For all of you who are in EMS...Are you also having this problem?
We were notified last week that there is a nationwide shortage of D50. We are using what we have sparingly, and have been told not to expect any until mid September. The alternative is glucagon. This is very bad news for diabetics who need EMS for hypoglycemia. This could cost lives.
Lasix (furosemide) is also in short supply. Luckily, we switched to Bumex some time ago, but there are agencies in the area that are scrambling to find alternatives, then modify protocols and conduct training in order to make a change to a more available drug.
Today, we got a memo that there are no prefilled syringes of epinephrine 1:10,000 to be had anywhere. That leaves us with two options:
- Instead of pushing 1mg of epi every 3 to five minutes for codes, we are going to be doing epi drips at 200mcg per minute in a drip.
- We can make our own 1:10,000 through other means, like mixing it as needed from epi 1:1,000 ampules.
Both of these take time and distract medics from working the problem.
All of this has me wondering: What happened? Why did the other makers of these drugs go out of business? Is this because of Obamacare?
2 comments:
Haven't heard about the D50, but have heard about the other two. We're told that we have plenty of epi for now, but Lasix is in short supply. We don't use Lasix all that much these days, but epi is pretty important.
From what my medical director said, all pre filled syringes of epi are actually made by one company, no matter who labels and sells it.
If we're seeing three commonly used EMS drugs in short supply, what's going on in the rest of medicine?
I have to wonder if this is somehow related to the health care law.
We stopped using lasix about 6 months ago when our new medical director came in, not that anybody really used it much with the majority of calls within 10 min of one of the 10 hospitals here in the metro and aggressive use of CPAP. epi were screwed, and D50 OMG we seem to have a staggering number of poorly controlled diabetics in this town. I did some research and came upon a website from a pharmacy group that had recalls and shortages of medications and why and the MFG IMS lost certification for their syringe medications and the stuff was so cheap that only one place made the stuff. never found any reason they lost certification. http://www.fda.gov/Drugs/DrugSafety/DrugShortages/default.htm And in typical fashion nobody told us anything till we were asking for resupply and were told "oh we don't have any" No alternate plans, no instructions of how to treat folks with no necessary medications. several days later we were told to remove all remaining D50 from our kits and trucks and turn them in and when you start the shift now you go out with one amp of D50 i have even seen some D25 that some enterprising young medics obtained from a hosp somewhere (and of course told not to use because it had not been approved)
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