Drug Shortages Begin: Tennessee Ambulances Face Drug Shortages

Tennessee ambulances face drug shortages

Nikki McGee

As drug shortages sweep the country, ambulances in Tennessee are really feeling the pinch with one of their most commonly-used medications. 

According to Rick Valentine, president of the Tennessee Ambulance Service Association, some of the most common calls they get are for diabetic patients experiencing hypoglycemia. Often times, they’re unconscious and paramedics reach for D-50, a form of dextrose that’s able to wake the patient in about a minute. 

“The brain is bathed in sugar, and so when it is depleted of sugar levels, it affects the brain and how it functions,” Valentine explained. “Getting that blood glucose level back to a normal level is very key, and it’s just unfortunately taking longer when you don’t have the D-50 that you need.” 

Physicians with the Tennessee Ambulance Service Association have come up with an alternative solution: using IV bags with a lower concentration of dextrose. However, they warn it could now take closer to 15 to 20 minutes to get a patient back to consciousness, versus the 60 to 90 seconds they’re used to. 

“It hits home when it’s one of the medications that you’re using a lot and it’s a critical medication,” Valentine said.  

Most departments have orders out for D-50 and are waiting for them to get filled. In the meantime, they want patients to know they’re doing everything they can with workarounds, and they’re still committed to saving patients, even if it takes a bit longer. 

“I think it’s more stressful, certainly for the family members that are there,” Valentine said. “You know, they’re saying, ‘What’s taking so long?’ and we just have to explain that it’s a different concentration, it’s a lower dose of sugar, and that it’s taking longer to get them back and awake,” Valentine said. 

According to the Food and Drug Administration (FDA), Pfizer sent out a manufacturing delay letter in August 2022, but the shortage is expected to last until December 2023.

In addition to D-50, Valentine said ambulances have also experienced narcotic shortages, but those are usually easier to cope with by using an alternative medication.