Returning to the Basics: Embracing Oral Rehydration Therapy During an Intravenous Fluid Shortage After Hurricane Helene.

In developed countries, the use of intravenous (IV) fluid for fluid resuscitation and other routine medical or surgical indications has become standard practice, with its availability often taken for granted. However, natural disasters can disrupt supply chains, leading to shortages. In September 2024, Hurricane Helene rendered the Baxter Healthcare facility in North Carolina inoperable, halting production and disrupting the supply of IV fluid in the U.S. In contrast, countries with limited access to IV fluid have long relied on oral rehydration therapy (ORT) as the cornerstone of fluid resuscitation and replacement. The well-documented efficacy of ORT provided a viable alternative to IV fluid for managing volume and electrolyte loss in the aftermath of the hurricane. This case series presents two patients, one with nephrogenic diabetes insipidus and the other with acute tubular necrosis due to dehydration, who were successfully treated with ORT, reinforcing its potential role as a practical solution during IV fluid shortages.