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Updated: Aug 6, 2026
06:59
A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings
Published on: November 9, 2016
A Systems-based Emergency Department Intervention to Conserve Intravenous Fluids During a National Shortage
Phillip D Jenkins1, Obert Xu1, Kenneth DeVane1
1Oregon Health & Science University, Department of Emergency Medicine, Portland, Oregan.
The Western Journal of Emergency Medicine
|August 4, 2026
Summary
A multiphase intervention significantly reduced emergency department (ED) intravenous (IV) fluid use by 56% during a national shortage. This systems-based strategy combined education, protocol changes, and electronic health record (EHR) tools, proving effective for resource stewardship.
Area of Science:
- Quality Improvement
- Healthcare Operations
- Emergency Medicine
Background:
- National intravenous (IV) fluid shortages, triggered by events like Tropical Storm Helene, highlight supply chain vulnerabilities.
- Emergency departments (EDs) commonly use IV fluids, making them susceptible to shortages.
- A multiphase intervention was developed to reduce non-essential IV fluid utilization in an ED setting.
Purpose of the Study:
- To implement and evaluate a systems-based conservation strategy to reduce total IV fluid use in the ED.
- To achieve a minimum 25% reduction in total IV fluid use through a staged intervention approach.
- To assess the impact of the intervention on daily IV fluid administration volumes and per-encounter usage.
Main Methods:
- A single-center, retrospective, pre-post quality improvement initiative was conducted in a tertiary academic ED.
- Interventions included clinician education on fluid stewardship, protocol modifications for routine IV placement, and electronic health record (EHR) clinical decision support tools.
- Daily IV fluid administration volumes and ED census data were analyzed from September 2024 (pre-intervention) and November 2024 (post-intervention).
Main Results:
- Average daily IV fluid use decreased by 56.0%, from 56.3 to 24.8 liters (P < .001), with stable ED volume.
- Per-encounter IV fluid administration reduced by 56%, from 0.36 to 0.16 liters per visit (P < .001).
- Estimated daily cost savings of $63 were associated with the reduction in IV fluid expenditures.
Conclusions:
- A structured intervention combining education, protocol changes, and EHR decision support effectively reduced ED IV fluid use without operational disruption.
- This approach demonstrates a scalable model for resource stewardship during future supply chain crises.
- The most significant reductions in IV fluid use were observed during the EHR-based decision support phase.
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