Propofol shortage

[suckulator]

I work in a large hospital near Syracuse NY and apparently there is a Propofol shortage. Is anyone else experiencing this? So basically at the end of this week we will be completely out of it. We also do not have any Etomidate or thiopental for some odd reason. So we have to put patients to sleep with 5 ml Propofol (while it lasts) and then breathe them down which as you know people hate! We have been giving them a higher dose of Versed in hopes they won't remember.

[Rose_Queen, BSN, MSN, RN]

Not quite that bad here, but we've switched from using IV Propofol during CPB to using sevoflurane through the bypass machine with our open heart patients. Also, no more keeping Propofol in the Pyxis in each OR- has to be picked up on a case by case basis from the pharmacy.

[CapeCodMermaid, RN]

I get a weekly list from the pharmacy on drugs that aren't available. The list gets longer every week.

[mmutk, BSN, RN, EMT-I]

It's gotten so bad in our ICU that we now use Fresenius Propoven 1%, which is just propofol made by a different manufacturer possibly in another country. The only difference from propofol is it's made with peanut instead of egg.

[SandraCVRN]

With so many peanut allergies these days I wonder how that is going to work out. It seemed like we had a problem with propofol a while back but I haven't heard anything lately.

[meandragonbrett]

Your anesthesia staff can use Ketamine, Versed, Fentanyl, methohexital, etc. to induce

[suckulator]

Yeah I know, we are using a combo. It's just not the same smooth induction and I would not want to have surgery right now. I'm sure as we go along AD will get better. We have used it for so long. Thanks for replies.

[FurBabyMom, MSN, RN]

I have noticed that our anesthesia team has been more conservative with propofol - and it's been a while since I've seen a propofol drip during a case. I have also seen some ketamine and other options/cocktails used instead of propofol depending on the patient/CRNA or MD anesthesia resident, and/or anesthesia attending preference.

For us, right now, the issue is epi. We are critically low. Almost all of our services (OR wise) use it, but at the moment and for the imminent future what little we have house-wide is reserved essentially for codes... We have so very little right now, it's embarrassing.

[suckulator]

Wow Epi? I guess I will stop complaining!

[FurBabyMom, MSN, RN]

Haha, yeah. Epi. Central pharmacy and our OR satellite pharmacy are hoarding what we do have of epi (the little amounts not in our code drug supply). Some of our service lines use it as if it were 0.9% NaCl... And many of our other docs like using epi so they don't have to deal with bleeding. Luckily we have (knocks on wood) a reasonable supply of bupivacaine, xylocaine etc with epi mixed in anyways. Ugh. At least there are multiple other ways...including some very expensive ways...to control bleeding. I would like to save my patients money if possible, but there are tons of options we can use in the OR if docs are using the epi for bleeding, so rationing to have some available for other patient's code situations is more important.

I looked on the FDA website, the part for drug shortages... Oh boy, what a list.