Update - 18 June 2025
- Updated data modelling is being undertaken by the TGA to review IV fluids supply and demand, with outcomes to be discussed at the National Response Group’s June meeting. The TGA will provide an update to the information on their website, About the shortage of intravenous once available.
- Victoria’s main IV fluids supplier has advised of a routine plant maintenance period at their Australian manufacturing facility from 7 to 21 July 2025. This is a routine, regulatory compliance activity that occurs twice a year – typically in July and over the Christmas/New Year period.
- This is anticipated to impact the supply of sodium chloride 0.9% 100mL IV infusion bags. Current local production is meeting approximately 80% of demand.
- The supplier is seeking to import an equivalent overseas product to assist with managing the anticipated reduced supply. Arrival dates of this stock will be confirmed once available.
- Sodium chloride 0.9% 100mL bags are expected to continue to experience reduced supply.
- Health services are advised to continue to utilise the recommended conservation strategies (detailed below) over the next 6-8 weeks to manage the reduced supply.
- HealthShare Victoria (HSV) is actively working with suppliers to ensure continuity of supply. Further details will be provided once available.
- The Commonwealth Government have taken measures to address the ongoing IV fluid shortage, including a commitment to expand onshore IV fluid manufacturing.
- Escalate concerns about supply to HealthShare Victoria by emailing supplychainsurety@healthsharevic.org.au. For general enquiries, email CPLU@safercare.vic.gov.au.
Clinical update - 12 June 2025
Conservation strategies for sodium chloride 0.9% 100mL bags
To preserve limited stock of sodium chloride 0.9% 100mL IV bags, clinicians should:
- Use 10mL ampoules for reconstitution, IV bolus administration, and line flushing.
- Choose the most appropriate volume of sodium chloride 0.9% based on current stock for drug dilution, flushing, or “to keep vein open”.
- Flush, lock and cap vascular access devices (VADs) when not in use, instead of continuous infusions.
- Use IV bolus or syringe driver administration over bag infusions when appropriate.
- Use alternative routes (oral, subcutaneous, intramuscular) where clinically suitable.
Overview
There is currently a national shortage of intravenous (IV) fluid bags across multiple suppliers, with intermittent disruptions to supply expected to continue for at least the rest of the year.
A Clinical Advisory Group including representatives from Safer Care Victoria, the Department of Health, HealthShare Victoria and health services is meeting regularly to monitor the situation, provide advice, and consider further measures to be implemented.
A National Response Group has also been convened to coordinate a consistent response across the jurisdictions and sectors.
Actions
Each health service is required to assemble a team of relevant clinicians and support staff to lead the management of IV fluid supplies at the health service level to:
- Review, assess and implement recommended conservation strategies, ensuring due consideration of appropriateness and safety
- Monitor data on IV fluid usage and stock holdings
- Provide reports on stock, usage and conservation strategies as requested.
- Monitor for further updates following any TGA data modelling outcomes
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The fluids in the following table are the products most at risk of shortages. Allocated supply of these products will be based on historical usage.
The most at-risk product is sodium chloride 0.9% 100mL bags.
Description Volume Baxter Product Code Fresenius Product Code Sodium chloride 0.9% intravenous solution 1000mL AHB1324 K690531 Sodium chloride 0.9% intravenous solution 500mL AHB1323 K690521 Sodium chloride 0.9% intravenous solution 250mL AHB1322 FAH1322 Sodium chloride 0.9% intravenous solution 100mL AHB1307 FAH3015 Sodium chloride 0.9% intravenous solution 50mL AHB1306A FAH3038 Compound sodium lactate (Hartmann’s solution) intravenous solution 1000mL AHB2324 K694531 Compound sodium lactate (Hartmann’s solution) intravenous solution 500mL AHB2323 K694521 Glucose 5% intravenous solution 1000mL AHB0064 K691531 Glucose 5% intravenous solution 500mL AHB0063 K691521 Glucose 5% intravenous solution 250mL AHB0062 FAH0062 Glucose 5% intravenous solution 100mL AHB0087 FAH3013 Glucose 5% intravenous solution (Viaflo bag) 250mL BSE0062 Baxter Glucose 5% intravenous solution (Viaflo bag) 500mL BSE0063 Baxter Glucose 5% intravenous solution (Viaflo bag) 100mL BSE0087 Baxter -
The Clinical Advisory Group, led by Safer Care Victoria, has developed recommended conservation strategies.
Health services are to review, assess and implement the recommended conservation strategies ensuring due consideration of appropriateness and safety. Refer to the Safety Considerations for further information.
IV fluids are used for 3 main purposes:
- IV hydration
- flushing and management of vascular access devices (VAD) and
- to administer medicines.
The conservation strategies described here have been grouped by area of practice and according to these main purposes.
General use
General advice
Review patients currently prescribed IV infusions and switch to alternative routes of administration as soon as clinically feasible.
Minimise fluid wastage by preparing fluids or infusions only when required, and not in advance.
Use a fluid type and volume that is most appropriate for the indication and current stock level (“most stock of at that time”). Seek advice from Pharmacy.
Ensure there are various sized pressure bags available for arterial and central line monitoring so that an alternative bag size can be used in the event of a shortage.
Do NOT use IV fluids for non-IV administration or use including off-label use (for example, wound flushing, eye irrigation or as traction devices).
IV hydration
Use oral or nasogastric routes of administration for hydration where possible.
Flushing and management of IV access
Use a volume of sodium chloride 0.9% most appropriate for current stock levels (“most stock of at that time”) for purposes of “drug and flush” or “to keep vein open” and VADs should be flushed, locked and capped where possible.
Administration of medicines
Use IV bolus injections or administration via a syringe driver.
Use alternative routes of administration such as oral, subcutaneous and intramuscular.
Use sterile Water for Injection ampoules instead of sodium chloride 0.9% for reconstituting IV medicines where compatible. Refer to the Australian Injectable Drugs Handbook for information.
Surgical patients
IV hydration
Minimise fluid fasting in surgical patients by encouraging clear fluids up until 2 hours prior to surgery. This may include instructing same day admission patients to drink water before leaving home and/or providing water on arrival if timing allows. The Sip Til Send protocol should be considered particularly for inpatients as surgery may be delayed. There are some patients to whom this guidance may not apply, such as those at increased risk of aspiration. For more information please review Sip Til Send , SaferCare Victoria.
Consider the need for routine use of IV fluids. Where postoperative IV fluids are necessary, consider the rate and duration of administration with review as required.
General advice
Consider indications for arterial pressure monitoring and sampling ensuring a clinical need exists.
Continue using irrigation fluid bags and bottles for peritoneal lavage and other body cavity lavage. The manufacturers have confirmed that these irrigation fluids have been produced and packaged with the same sterility standards as IV fluids but as they are intended for irrigation, they cannot be used intravenously.
Maternity patients
General advice
Do NOT use IV fluids for non-IV administration including off-label use (for example, heat packs)
IV hydration
Encourage oral fluids while in labour, as tolerated. Only use IV fluids where there is a clinical indication.
Maintain strict fluid balance for all women during labour and birth.
Review the need for post-operative fluids in women who can tolerate oral fluid intake.
Administration of medicines
Restrict tranexamic acid prophylaxis planning for women with post-partum haemorrhage risk. Administer 1g undiluted over 10 minutes.
Use antiemetics to treat hyperemesis and test oral fluid intake. Reserve IV fluids for severe cases.
Use ferric carboxymaltose (Ferinject®) for IV iron infusions. Inject doses of up to 500 mg undiluted at a maximum rate of 100 mg/minute. Inject doses of 500–1000 mg undiluted over 15 minutes. Slow IV administration is necessary to reduce the risk of extravasation and skin staining.
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General
Only use fluids labelled for intravenous use for injection or infusion. Ensure clinicians and staff involved in supply of fluids are aware that fluids marketed for irrigation are unsuitable for injection or infusion.
All fluid bags, including those that are locally manufactured, contain air in the bag. Higher volumes of air may increase the risk of air embolism. To minimise this risk:
- Administer IV fluids via a volumetric infusion pump or other device with air in- line detection where possible.
- Where a pressurised infusion is required, it is recommended to:
- Remove the air from the bag
- Secure the bag horizontally and inflate the cuff prior to hanging
- Hang the cuff and bag vertically
- Monitor the line closely for the presence of air for the duration of the infusion.
For further information, see:
- Risk of air embolism when administering intravenous fluids, Safer Care
- Information for clinicians – Intravenous (IV) fluid bags – International alternatives and associated safety considerations, .
Digital configurations
Consider the need to adjust eMM/EMR settings and/or IV pumps to facilitate safe use of conservation strategies.
- Alerts to notify clinicians of supply disruption.
- Clinical decision support for medicine administration utilising smaller fluid volumes and/or alternative routes.
- Updates to the medication library on syringe pumps and large volume pumps to facilitate conservation.
- Links to Safer Care Victoria guidance as appropriate.
Preparation of intravenous infusions of medicines
Ensure compatibility of IV medicines with the selected diluent and ensure the final concentration is within the acceptable range for administration/stability. Refer to the Australian Injectable Drugs Handbook and the Paediatric Injectable Guidelines via Clinicians Health .
Features of IV fluid bags, including overfill and maximum volume that can be added as well as comparison of constituents is available in the Australian Injectable Drugs Handbook.
Some medicines such as ciclosporin, tacrolimus and diazepam are incompatible with polyvinyl chloride (PVC) and some IV fluid bags may not be appropriate for administration of these medicines.
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Reporting
Escalate to HSV in circumstances where there is less than five days' supply for a product and there is not a clinically acceptable alternative available.
Stock management
Limit stock levels held in clinical areas and conduct regular stock counts to inform escalations.
Reserve stock of the product in limited supply for use in circumstances where other volumes or fluids are not suitable.
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The Therapeutic Goods Administration (TGA) has approved overseas registered IV fluids under Section 19A. Refer to the TGA . Consider risk minimisation strategies to ensure the safe use of these alternatives, particularly given differences in presentation and volumes of air.
Safer Care Victoria has published guidance to support health services in managing this .
Reviewed 17 June 2025