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It Takes a Village…
Copyright policy )Critical drug shortages have been widely documented during the coronavirus disease 2019 (COVID-19) pandemic, particularly for IV sedatives used to facilitate mechanical ventilation. Surges in volume of patients requiring mechanical ventilation coupled with prolonged ventilator days and the high sedative dosing requirements observed quickly led to the depletion of "just-in-time" inventories typically maintained by institutions. This manuscript describes drug shortages in the context of global, manufacturing, regional and institutional perspectives in times of a worldwide crisis such as a pandemic. We describe etiologic factors that lead to drug shortages including issues related to supply (eg, manufacturing difficulties, supply chain breakdowns) and variables that influence demand (eg, volatile prescribing practices, anecdotal or low-level data, hoarding). In addition, we describe methods to mitigate drug shortages as well as conservation strategies for sedatives, analgesics and neuromuscular blockers that could readily be applied at the bedside. The COVID-19 pandemic has accentuated the need for a coordinated, multi-pronged approach to optimize medication availability as individual or unilateral efforts are unlikely to be successful.
Microsoft Academic Graph classification: Supply chain Intensive care medicine medicine.medical_specialty medicine Context (language use) business.industry business Neuromuscular Blockers Economic shortage Hoarding (economics) Drug media_common.quotation_subject media_common Pandemic Coronavirus disease 2019 (COVID-19)
Cardiology and Cardiovascular Medicine, Critical Care and Intensive Care Medicine, Pulmonary and Respiratory Medicine
Cardiology and Cardiovascular Medicine, Critical Care and Intensive Care Medicine, Pulmonary and Respiratory Medicine
Microsoft Academic Graph classification: Supply chain Intensive care medicine medicine.medical_specialty medicine Context (language use) business.industry business Neuromuscular Blockers Economic shortage Hoarding (economics) Drug media_common.quotation_subject media_common Pandemic Coronavirus disease 2019 (COVID-19)
- University of Toronto Canada
- Naval Medical Center San Diego United States
- Uniformed Services University of the Health Sciences United States
- University of Minnesota Morris United States
- University of Arizona United States
- University of Toronto Canada
- Naval Medical Center San Diego United States
- Uniformed Services University of the Health Sciences United States
- University of Minnesota Morris United States
- University of Arizona United States
- Dartmouth College United States
Critical drug shortages have been widely documented during the coronavirus disease 2019 (COVID-19) pandemic, particularly for IV sedatives used to facilitate mechanical ventilation. Surges in volume of patients requiring mechanical ventilation coupled with prolonged ventilator days and the high sedative dosing requirements observed quickly led to the depletion of "just-in-time" inventories typically maintained by institutions. This manuscript describes drug shortages in the context of global, manufacturing, regional and institutional perspectives in times of a worldwide crisis such as a pandemic. We describe etiologic factors that lead to drug shortages including issues related to supply (eg, manufacturing difficulties, supply chain breakdowns) and variables that influence demand (eg, volatile prescribing practices, anecdotal or low-level data, hoarding). In addition, we describe methods to mitigate drug shortages as well as conservation strategies for sedatives, analgesics and neuromuscular blockers that could readily be applied at the bedside. The COVID-19 pandemic has accentuated the need for a coordinated, multi-pronged approach to optimize medication availability as individual or unilateral efforts are unlikely to be successful.