Balancing Medication Shortages during COVID-19

We hear the verbiage “more ventilators" and the number of patients on “invasive ventilation” frequently in relation to COVID-19. We know life-saving technology, critical sedation, analgesia, and at times, paralyzing agents are needed to assist with ventilation. How do we balance the increased need for medications with limited availability? Suitable workarounds, such as benzodiazepines for traditional shorter-acting medications that are in short supply, or using bolus versus infusion for certain types of drug regimens may be an option.

There is a delicate balancing act. Daily patient interdisciplinary rounding is an opportunity to evaluate medication regimens, both for types, interchangeability, drug

dosing, interactions, and need. Be sure to actively participate and be the voice of your patient. Continue to utilize our assessment tools: CAM-ICU, CPOT, and RASS scores to assist in the management of medications, and remind staff who may not be as familiar with them.

Are there specific medications in short supply at your organizations? What strategies are you utilizing to mitigate shortages?

Resources:

Additional Resources:

• https://www.fda.gov/drugs/drug-safety-and-availability/drug-shortages

• https://www.thebureauinvestigates.com/stories/2020-04-09/drug-shortages-put-worst-hit-covid-19-patients-at-risk

References:

• https://www.sccm.org/getattachment/1734a789-a8a5-4b20-bc97-15dfec30ba8b/Implementing-the%E2%80%AFD-Component-of-the-ABCDEF-Bundle

• https://www.researchgate.net/figure/Critical-care-pain-observation-tool-CPOT_fig3_337928045

• https://www.grepmed.com/images/1465/assessment-diagnosis-agitation-richmond-sedation-nursing-scale

• https://www.medpagetoday.com/infectiousdisease/covid19/85917