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Rationing Salt Water -- Disaster Planning and Daily Care Delivery
New England Journal of Medicine (2014)
  • John L Hick, MD, Hennepin County Medical Center
  • Dan Hanfling, Inova Health System
  • Brooke Courtney, J.D., M.P.H.
  • Nicole Lurie, M.D., M.S.P.H., Department of Health and Human Services
The national shortage of normal saline... represents a new chapter in supply shortages. The administration of normal saline (and other crystalloids) is a basic underpinning of patient care. In many ways, it is more the lifeblood of hospital care than blood itself. As supply-chain disruptions have caused a shortage of saline, demand for alternatives has spiked, causing a ripple effect. As hospitals increase their product orders to compensate for the shortage, the backlog of orders awaiting delivery grows. The fact that health care facilities would have to ration the use of such a fundamental resource is perhaps the most significant demonstration yet of the importance of addressing these vulnerabilities.

So what should we do? 
  • scarce resource allocation,
  • crisis standards of care,
  • disaster planning
Publication Date
March 19, 2014
Citation Information
John L Hick, Dan Hanfling, Brooke Courtney and Nicole Lurie. "Rationing Salt Water -- Disaster Planning and Daily Care Delivery" New England Journal of Medicine Vol. 370 (2014) p. 1573 - 1576
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