American Society of Regional Anesthesia and Pain Medicine August 2018 - 14

syringes to decrease medication waste during a drug shortage
crisis as well as save a significant amount of money.
* Consider the ethics of practicing anesthesiology and
surgery during this era of drug shortages. By their nature,
anesthesiologists readily adapt to change, but a line has to
be drawn somewhere. ASA has a statement on the ethical
considerations with drug shortages that includes two key points:30
▷ "Anesthesiologists, as well as surgeons and other
proceduralists, should consider postponing an elective
procedure when the risks of proceeding might outweigh the
risks of using medications that are alternative to those in
short supply or unavailable."
▷ "If the anesthesiologist judges the risk of increased
morbidity or mortality by using alternative medications
to be negligible, then there is no need to discuss this
issue when obtaining informed consent. However, if the
anesthesiologist judges the added risk to be significant,
then the discussion of alternative plans should be part of
the informed consent process."
* Keep working towards a longer-term solution to drug
shortages through improvements in the supply chain. Some
health systems have established partnerships with existing
pharmaceutical manufacturers in an attempt to provide more
stability in drug availability in the future. Recently a few major
health systems have announced the creation of a new nonprofit
generic drug company.31
* Raise awareness in the community about the potential impact
of analgesic drug shortages on quality and safety. If the general
public is sufficiently concerned, legislators and regulators may
be more likely to take action.
ASA is currently working on multiple levels in the United States
government on behalf of patients and the anesthesiologists who
care for them.32 ASRA leaders will be working closely with ASA
during this ongoing crisis to provide guidance to members on how
to manage ongoing and ever-changing drug shortages and continue
to provide the safest, high-quality care to patients.
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American Society of Regional Anesthesia and Pain Medicine
2018

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Table of Contents for the Digital Edition of American Society of Regional Anesthesia and Pain Medicine August 2018