Many hospitals across the country faced a critical shortage of intravenous (IV) saline at the end of 2024. Hurricane Helene in North Carolina (NC) significantly damaged Baxter's manufacturing plant in North Cove, NC, and the roads and bridges that supply the plant.1 This single facility provided 60% of IV fluids for the US market, leading to the critical shortage of IV fluids, which impacted adult and pediatric hospitals. The resulting crisis has led to a requirement for rationing existing IV saline supplies, recommendations for using oral rehydration solution for dehydrated hospitalized patients,2 pharmacists compounding medications more conservatively,3 the Food and Drug Administration (FDA) extending emergency import licenses for IV saline, and extending product expiration dates for the existing IV supply inventory.4, 5 Patients on dialysis (peritoneal dialysis or hemodialysis) also required modified workflows given the volume of fluid involved in the kidney filtration process.
