Drug Shortages

[Jon]

I've noticed a disturbing trend in drug availability in the last 6-8 months or so (and even longer). This isn't lost on anyone anymore - it's made national news, and was a huge subject of discussion at EMSToday.

But even though we see the problem - how do we fix it?

What is YOUR service doing about drug shortages? How are you coping? Can you link to any policies or other info?

 

[Handsome Robb]

I've noticed a disturbing trend in drug availability in the last 6-8 months or so (and even longer). This isn't lost on anyone anymore - it's made national news, and was a huge subject of discussion at EMSToday.

But even though we see the problem - how do we fix it?

What is YOUR service doing about drug shortages? How are you coping? Can you link to any policies or other info?

The only shortage that has messed with us is the fentanyl shortage.

We have some odd setup with the fentanyl we have now. I don't know where it comes from but it definitely isn't from a "top of the line" company. It is a bit odd the way the vials are setup but the DEA says it's fine and we use it every day without complaint so....

 

[DesertMedic66]

The only thing I have noticed us change is the exp date being changed so that we have the meds roughly 4 months past the printed exp date.

 

[Aidey]

Last count that I saw was 283 different drugs had shortages. Including fentanyl, morphine, dilauded, zofran, reglan, etomidate, versed, ativan, narcan, succinylcholine, and rocuronium. And those are just the common EMS meds I can remember off of the top of my head.

In the short term, we preserve our supplies by actually farking refrigerating meds that are supposed to be refrigerated. In the long term there is nothing we the EMS community can do. It is going to take some people waaaay up there to force the drug companies and insurance companies to play nice with each other.

 

[tacitblue]

I've noticed a disturbing trend in drug availability in the last 6-8 months or so (and even longer). This isn't lost on anyone anymore - it's made national news, and was a huge subject of discussion at EMSToday.

But even though we see the problem - how do we fix it?

What is YOUR service doing about drug shortages? How are you coping? Can you link to any policies or other info?

I was reading the other day of an acute shortage of a particular curative chemotherapy drug that has pediatric oncologists saying that kids with leukemia are actually going to die. Scary.

 

[abckidsmom]

I was reading the other day of an acute shortage of a particular curative chemotherapy drug that has pediatric oncologists saying that kids with leukemia are actually going to die. Scary.

Super scary. This is real and true. I love a little girl whose chemo may be out if stock when her next round comes up.

 

[Jon]

Well, my boss was psychic, I think. He accidentally ordered a case of Ativan a few months back. I have a sneaking suspicion we won't run out there. We've been out of fentanyl for a month, with pushed-back re-supply dates.

Over the last year, I've run out of Zofran - and did anyone else have trouble getting prefilled D50? Drawing D50 up from a vial is a MESS!

 

[epipusher]

Our service is finally well stocked on Fentanyl. Our versed seems to still be running short.

 

[Farmer2DO]

and did anyone else have trouble getting prefilled D50? Drawing D50 up from a vial is a MESS!

We were out of prefilled D50 and bicarb. Had to draw them both up.

 

[Devilz311]

and did anyone else have trouble getting prefilled D50? Drawing D50 up from a vial is a MESS!

We did about a year ago, but since then they've been in the normal bristojets.

The 50mL vials the D50 came in was a royal PITA to draw up...

 

[Dwindlin]

In this region we switched to D5W infusions for our hypoglycemics due to supply issues.

 

[rmabrey]

We switched to Ativan during the Valium shortage. Switching to Diprivan with the Etomidate shortage. As far as I know we only use fentanyl with peds (read not often).

Haven't noticed and shortages of dilaudid or morphine, however we are getting the break top vials of dilaudid(can't remember what they are called). That's an issue since we don't have filter needles.

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[Jon]

The 50mL vials the D50 came in was a royal PITA to draw up...

Yeah... and everything became sticky, no matter what you did.

Thankfully my service never ran out of pre-filled. My exposure was playing on the BLS side with other ALS responders (except that somehow drawing up that blasted D50 fell to me more than once).

We've been using Fentanyl as our go-to analgesic for a couple of years now, with morphine as a second-line option for traumatic injury, and primary for cardiac patients (it's the way the local docs like it).

Now I've got 2 vials at the slow 911 squad, and none left at the busy one. Oh, and we've ordered more morphine... and that's backordered now too. Lets hope we get it in before we run out.

 

[bigbaldguy]

Richest country in the world and we might run out of drugs, very sad. Well if we can't get our meds we might have to do what poor elderly Americans do and get on a bus drive to Canada and buy them there. Might be cheaper too

In all seriousness I wonder if this will force more realistic expiration dates to be used. I think we've all seen the amount of wasted meds and supplies that are trashed because they've "expired" even though you know they're still perfectly usable.

 

[Handsome Robb]

We switched to Ativan during the Valium shortage. Switching to Diprivan with the Etomidate shortage. As far as I know we only use fentanyl with peds (read not often).

Haven't noticed and shortages of dilaudid or morphine, however we are getting the break top vials of dilaudid(can't remember what they are called). That's an issue since we don't have filter needles.

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An ampule? If your agency is using ampules they absolutely need to use filter needles to draw out of them. Sure you could probably get away with it but I wouldn't risk it. For some reason introducing tiny glass shards into someone's vascular space seems like a bad idea...

Fent is our first line for everyone except cardiac pt's then its MS first or Fent if their BP is borderline or if they have an allergy to MS.

In my limited experience I like MS>Fentanyl for abdominal pain and our docs don't have a problem with it unless we totally snow someone.

 

[rmabrey]

An ampule? If your agency is using ampules they absolutely need to use filter needles to draw out of them. Sure you could probably get away with it but I wouldn't risk it. For some reason introducing tiny glass shards into someone's vascular space seems like a bad idea...

Yeah those, and I agree. We aren't supposed to be getting ampules for that reason. But apparently that's all we can get.

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[Tommerag]

One service I work at we are out of zofran and can't get any for a while so we switched to compazine. The other service I work at just added fentynal, not sure if they are having problems getting it, because it hasnt been added to any of the trucks.

 

[ffemt8978]

Looks like it is even affecting Canada.

http://www.bbc.co.uk/news/world-us-canada-17320063