A global shortage of intravenous (IV) fluid products has hit Hunter hospitals, threatening surgeries and various other treatments.
The shortage is expected to continue this year, raising concerns about the effects on patients.
An internal Hunter New England Health email said the IV fluids shortage had "high importance".
"The critical disruption to the supply of multiple IV fluid bags is ongoing," it said.
It said a supply had been found in France, but the Olympics Games was delaying delivery this month.
The cost of this supply was 10-fold higher than "the Australian registered products".
A John Hunter Hospital source said "unless patients really need fluids, we need to be careful about using them".
The source said the problem could "potentially affect surgeries".
"If you have a patient that could need fluid resuscitation, they could hold off on that because they don't have fluids to do it."
Another source said the Calvary Mater was also low on stocks.
The NSW Clinical Excellence Commission issued a safety alert on the matter and recommended ways to conserve IV fluids.
"Use the smallest possible volume of IV fluids for the required indication. Use smaller bag sizes for slower rate infusions where possible," it said.
"Ensure regular review of patients receiving IV infusions and switch to alternative routes of administration as soon as possible.
"Regularly assess patients who may be suitable for oral hydration prior to the initiation or continuation of IV fluid therapy."
The commission listed antimicrobial drugs suitable for "IV bolus injection", rather than IV drips.
The Newcastle Herald contacted Hunter New England Health for comment, but was directed to NSW Health.
"To date, no elective surgeries in NSW public hospitals have been cancelled as a result of the IV shortages," a NSW Health spokesperson said.
"NSW Health, like all Australian health services, is being impacted by a current global shortage of multiple IV fluids.
"We are taking all available steps to minimise any potential disruptions to our services and patients caused by these supply issues."
The spokesperson said "Intravenous Fluids Stewardship Groups" had been established across all NSW Health facilities to provide expertise on IV fluids.
The groups would advise on IV fluid "management and conservation during this disruption to supply".
"NSW Health continues to work closely with our IV fluid suppliers and we are carefully monitoring and managing existing stock at facilities," the spokesperson said.
"We are also using alternative administration methods where clinically appropriate."
The Therapeutic Goods Administration (TGA) is working with health departments and suppliers of Australian and overseas-registered IV fluids to address the shortage.
A TGA statement said there were "shortages of multiple IV fluid products from all three Australian suppliers".
"IV fluids are essential medicines used in hospitals for routine and critical care.
"They are crucial for fluid replacement, resuscitation and administering other medications directly into the bloodstream."
The TGA statement said the shortages were "due to multiple factors including global supply limitations, unexpected increases in demand and manufacturing issues".
"To improve supply, we have approved multiple overseas-registered alternative saline fluids. We are continuing to prioritise evaluation of additional applications.
"Suppliers have advised us that supply will continue to be constrained throughout 2024."
