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Baking Soda Shortage Has Hospitals Frantic, Delaying Treatments and Surgeries (arstechnica.com)
An anonymous reader quotes a report from Ars Technica: Amid a national shortage of a critical medicine, US hospitals are hoarding vials, delaying surgeries, and turning away patients, The New York Times reports. The medicine in short supply: solutions of sodium bicarbonate -- aka, baking soda. The simple drug is used in all sorts of treatments, from chemotherapies to those for organ failure. It can help correct the pH of blood and ease the pain of stitches. It is used in open-heart surgery, can help reverse poisonings, and is kept on emergency crash carts. But, however basic and life-saving, the drug has been in short supply since around February. The country's two suppliers, Pfizer and Amphastar, ran low following an issue with one of Pfizer's suppliers -- the issue was undisclosed due to confidentiality agreements. Amphastar's supplies took a hit with a spike in demand from desperate Pfizer customers. Both companies told the NYT that they don't know when exactly supplies will be restored. They speculate that it will be no earlier than June or August. With the shortage of sodium bicarbonate, hospitals are postponing surgeries and chemotherapy treatments. A hospital in Mobile, Alabama, for example, postponed seven open-heart surgeries and sent one critically ill patient to another hospital due to the shortage.
Is this shortage happening in countries with "socialized medicine", or just in free market America?
I wouldn't trust commercial grade, but the FDA could save a ton of lives by allowing hospitals to buy food-grade and sanitize it and create their own solutions. The FDA and malpractice insurers would rather go after hospitals for trying to save lives than to recognize what's best for everyone.
I once worked in the analytical laboratory at J.T. Baker as an analytical chemist. I personally tested NaHCO3 among many other chemicals to USP, FCC, and ACS standards. We had a warehouse with plenty of barrels of these kinds of commodities. Also, I seem to recall that the ordinary box of Arm&Hammer on the supermarket shelf is actually very high quality material, almost pure enough to use for creating primary standard grade sodium carbonate by baking out some water and CO2 at a specific temp.
Note that the costs to certify to USP grade are little different than for the other grades. It is important to understand that many chemicals which come into a chemical plant never require any further purification. In such cases, a portion is split off to be packaged as ACS, another portion goes in the USP bottles, etc. The remainder can be sold off as "Technical" grade if there isn't enough room to store it. If there is room, it might be preferable to store the raw material that meets the higher specs. rather than sell it all off as tech. grade, because the next load that comes in might not meet the requirements for certs. and thus would need to go through a purification process.
What's sad about this story is that because of the regulatory/liability state, it is impossible to engage in simple acts of innovation ("winging it") that could solve problems such as this "shortage." E.g.:
Find a chemical company with some barrels of bicarb. that has been tested to one of the specs., or USP if possible. If they don't have the USP, then have them test the ACS or FCC to the USP std., which would probably pass if it already met one of the other stds.
Then just procure the damn stuff!
If additional sterilization is needed, have the truck routed to an accessible sterilization service. Ie., a facility with a gamma ray sterilization unit, where the material could simply be put on a belt and sent through the rays.
Hospitals should have the capability to filter small lots of solution to further remove any particulates if necessary.
But no, we'd rather incur large risks of an actual death to a patient to stave off some tiny risk.
What a pathetic thing we have become.
Highly optimised systems get increasingly fragile. A highly optimised market for drugs will falter on the slightest off-the-regular imbalance. Same goes for IT services. Imagine everything running on and with Google in 3 decades. And Google then having some kind of hickup that puts the entire society of humanity to a grinding halt for a few days. Or weeks.
A Utopia would have to be built taking this systemic problem into account. But then again, this might not be the best example. As we all know, the US medical system is about as far away from Utopia as it gets.
We suffer more in our imagination than in reality. - Seneca
Since hospitals quit having formulating pharmacies and went to outsourcing for common stock items like sterile saline, sterile bicarbonate solution, and sterile distilled water; they have been at the mercy of third party suppliers. Such common items are really a low profit item for suppliers that they don't stockpile such.
The trend to outsource instead of having employees and equipment to do things in house has been working its way into industry since the 1970s. And a hospital is very much an industrial installation when you get down to daily operation.
NRRPT/RCT