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Rationing Salt Water – Disaster Planning and Daily Care Delivery

Hick, J.L., Hanfling, D., Courtney, B., and Lurie, N.. (2014). Rationing Salt Water – Disaster Planning and Daily Care Delivery. The New England Journal of Medicine. 370:1573-1576.

This article describes managing critical resource shortages through an incident management system and utilizing the key stewardship components of the Institute of Medicine’s standards of care guidelines for catastrophic emergencies. This excerpt from the article describes specifically recommendations from a previous shortage, “during the recent saline shortages, for example, the Northern Virginia Hospital Alliance released a coalition-purchased disaster cache of intravenous fluids to member hospitals for their immediate use, stemming the need for restrictive conservation measures. Many hospitals offered guidance to providers on using alternative crystalloids or smaller bags, emphasizing oral hydration, enteral feeding, and reduced preoperative fasting times whenever possible. These policies are often shared with other facilities and through health care networks and response coalitions, resulting in consistent, community-wide practices.”
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