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Critical Drug Shortage

EMERGENCY INTERIM PROTOCOLS – DRUG SHORTAGES

The following ( pdf and attached (21 KB) ) protocols are in effect immediately to address current drug shortages affecting WVEMS and the nation. Please read and retain this information.

 

DEXTROSE pdf
(21 KB)

Due to a critical shortage of Dextrose, an interim protocol has been developed until there is adequate supply of D10 or D50.

Alternate protocol for hypoglycemia and altered mental status (typically FSBS <60) when no pre-filled syringes of D50, D25 or D10 are available.  Administer rapidly, may require mild to moderate pressure on bag. 

D10W in 250ml or 500ml IV bag:

            Adult dose 5 grams = 50ml (<0.1 gram/kg)

            Pediatric dose 0.1 grams/kg = 1ml/kg

            Repeat every 5 minutes based on FSBS and Mental Status

                                                            Or

 

D5W in 100ml, 250ml or 500ml IV bag:

            Adult dose 5 grams= 100ml

            Pediatric dose 0.1 grams/kg = 2ml/kg

            Repeat every 5 minutes based on FSBS and Mental Status

EPINEPHRINE

If there are no Epi 1:10,000, prefilled syringes in the box, use:

1 mg of Epi 1:1000 – mixed with 9 mL of Normal Saline

Epinephrine may be in your box as a 30 mL multi-dose vial, of 1:1,000 typically packaged 1mg/mL

SODIUM BICARB

There is no alternative drug that will be used in the place of Sodium Bicarb.  If the box does not have Sodium Bicarb in it, it will be marked with a sticker from the pharmacy, “No Sodium Bicarb”

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