Coronavirus: Alert issued to hospitals as intensive care drugs run low

NHS says it will take control of supplies for some intensive care drugs as coronavirus demand means some medications are at critical levels

Doctors have been warned some key medications are at critical levels (Getty/iStock)

Doctors have been warned that crucial drugs used to help sedate and ventilate patients in intensive care are running out due to the demand caused by coronavirus.

An alert to hospitals from NHS England today said there were “limited supplies” of muscle relaxant drugs atracurium, cisatracurium and rocuronium, which are used during intubation when patients are sedated and paralysed with a ventilator used to help them breathe.

As a result of the shortages, and to help maintain supplies, NHS England said it would now manage existing supplies “centrally”.

Its said supplies of atracurium and cisatracurium were likely to be exhausted in coming days, and hospitals would need to switch to alternatives that were still available.

In recent weeks, doctors have warned of shortages of other key drugs such as propofol, a commonly used anaesthetic, and alfentanil, an opioid painkiller which is used in intensive care.

A critical care nurse working in ICU in the south of England told The Independent they were already using alternatives but that this had to be used at different concentrations and run for longer to achieve the same sedation.

She said changes like this with staff overstretched could increase the likelihood of drug errors.

Drug shortages in the NHS and in intensive care are not unusual, and the Royal College of Anaesthetists said doctors were used to having to switch to different drugs.

The extra demand from coronavirus, which has seen thousands of extra patients admitted with Covid-19-related pneumonia and needing to be ventilated, has caused some drugs to run short.

NHS England said remaining stocks of atracurium and rocuronium would be allocated to hospitals based on modelling data and the number of patients in intensive care.

It added: “Stocks of cisatracurium in the supply chain are critically low and restock is not expected in the near future. Remaining stock is not at sufficient quantities to be centrally managed by allocations.”

It also said NHS England and the Department of Health and Social Care were working with suppliers and specialist importers to secure further supplies for the UK.

“We are also working with suppliers of other neuromuscular blocking agents to assess their supply position.”

The Royal College of Anaesthetists said intensive care staff were used to using alternative medicines adding: “It is important that NHS patients and the general public understand that drug demand-supply mismatch in anaesthesia and intensive care medicine are not unknown to us, even under normal circumstances.

“While we may not always be able to use our first choice drug, we expect to be able to use an appropriate alternative drug, therefore ensuring that all patients will receive effective medications.”