ADMIN & CLINICAL OPERATIONS
Supply Chain Disruptions: Why It’s Happening and What Can Be Done SAEM PULSE | SEPTEMBER-OCTOBER 2022
By Max Kravitz, MD, MBA; Meagan Hunt, MD; Derrick Huang, MD; and Megan Davis, MD, MBA, on behalf of the SAEM ED Administration and Clinical Operations Committee
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A supply chain is the network of all stages that it takes to deliver a finished product to a consumer. These include raw materials, conversion to inputs, production of end products, and delivery of those end products. Many health care products utilize a complex global supply chain with many stages before our usage, and these networks are vulnerable to disruption at all stages. These vulnerabilities have existed for some time, but COVID-19 and the associated lockdowns have stressed supply chains and unveiled weaknesses. Supply chain disruptions have impacted the lives of emergency physicians at home and work. From
the infant formula shortage to the IV lorazepam shortage, it seems something is always in short supply. At the time of this writing, many emergency medicine physicians still face a shortage of iodinated contrast. The iodinated contrast shortage has been particularly challenging because it has forced many emergency physicians to alter their typical diagnostic evaluation of numerous life-threatening diseases. Instead of a contrast CT scan, emergency medicine physicians may be asked to order a V/Q scan to evaluate for pulmonary embolism or ultrasound for appendicitis workup. This article discusses supply chains, why some disruptions occur, what steps
institutions should take to address shortages, and what should and should not be expected of emergency medicine physicians when shortages occur.
Iodinated Contrast Shortage
In the case of the iodinated contrast shortage, the Shanghai COVID-19 outbreak in April 2022 resulted in a two-month shutdown of the city due to China's strict zero-tolerance COVID-19 policy. This caused a global shortage of iodinated contrast media produced by GE Healthcare, which produces much of its contrast media in Shanghai-based facilities. Many health care systems in the United States utilize GE Healthcare as their preferred supplier for iodinated contrast, partly to save money through