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Baxter, one of the main producers of IV saline fluids, got power back its Puerto Rican plant in later December after weeks of outages.

"This is a serious situation and right now we are at the limits of our conservation and adaptation strategy", said Dr. Paul Biddinger, director of the Center for Disaster Medicine and vice chairman for emergency preparedness at Massachusetts General Hospital in Boston.

The worst shortage is for small saline bags.

"It's slightly earlier than what we normally see, but in the past few years we've had late seasons".

Shortages are also hitting surgery centers, cancer clinics that infuse chemotherapy, dialysis centers and companies that provide regular infusions to home-bound patients.

To help support the USA market facing short supply of products, Baxter worked with the FDA to import certain products, including small-volume parenterals, from Baxter facilities in Ireland, Australia, Canada, Mexico, England and Italy.

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According to a statement emailed to the Globe, Mercy Hospital Joplin checks inventory levels on a daily basis, and when potential for a shortage appears imminent it moves to another supplier.

The Tennessee Department of Health has recorded four flu-related deaths in the state during the 2017-2018 flu season. While this shortage appears bigger, hospitals have dealt with shortages before, Thompson said, so they'll keep monitoring supplies - and knocking on wood.

Hospitals have been substituting pills for IV-administered drugs when possible, changing dosing schedules or injecting drugs directly into a vein, what's called IV push.

On the positive side: Hospitals may find ways to permanently reduce use of saline bags.

"The small bags disappeared and we accommodated for that by making things ourselves and doing conservation techniques", said Britton.

A carbon fee and dividend, proposed by Citizens' Climate Lobby, is an effective economic incentive to shift us toward renewable energy and new technology that bypasses fossil fuel.