A shortage of saline bags commonly used in medicine is affecting the delivery of medical care at one medical practice.

Dr. James Atkins, with the Southeastern Medical Oncology Center, said supplies of the IV bags are at critically low levels, with the lack of shipments during the past five days.

"We order our fluids every day and, I think, the last four or five days, we've gotten none -- zero," Atkins said. "We're getting to the point to where it's a critical shortage."

The medical practice regularly uses saline intravenously during chemotherapy treatments, along with nausea medicines and to hydrate patients. The lack of supply has led to prioritizing supplies.

IV iron treatments are not being provided, and patients are not able to receive nausea medicines intravenously. Other alternatives are being considered for nausea medicines, some which are more costly to patients such as shots and patches, Atkins said.

"If somebody needs iron, we can't give it because it has to be mixed in saline," Atkins said. "We have to save the saline for our cancer patients. It's impacting how we're able to care for our patients by not having access to enough saline to meet our needs."

A key U.S. maker of hospital products, Baxter International, predicted saline product shortages following hurricane damage in Puerto Rico, which led to electrical outages and disruption of manufacturing operations. The products affected are smaller-volume bags of sodium chloride, known as saline.

In an effort to prevent shortages, the FDA gave Baxter International permission to import saline from its manufacturing sites in Australia and Ireland.

Atkins said the shortage is resulting in limited supplies of all saline bag sizes, including the larger 1-liter bags, commonly used to hydrate patients.

"We're going day by day," Atkins said. "We're on a day-by-day schedule.

"We can only hope that the government can find out how to make these fluids more available so that we can give our treatments."

Melissa Shay, vice president of strategy and business development at Wayne UNC Health Care, said that the hospital is continuing to manage its supplies, and no medical services are being disrupted.

"Shortages of some drugs and other medical supplies present an ongoing challenge for hospitals across the United States," Shay said.

"Some of those supply challenges have been made worse by the hurricane damage in Puerto Rico and production problems at manufacturing plants.

"UNC Health Care, including Wayne UNC Health Care, has contingency plans in place, and a team of people working daily to find new sources for some supplies, implement conservation measures and use alternative medical products when possible.

"Our top goal is to treat all patients in a safe and appropriate manner, and we are doing our best to mitigate any impact on our patients' care."