TREASURE VALLEY -- Hospitals across the nation continue to battle a shortage of IV solution bags - now, amid an early and aggressive flu season.

Hospitals are having to get creative, including those here at home. Area hospitals - like many across the country - have been wrestling with this shortage for months. But now, they're seeing an increase in patients into their emergency rooms because of the flu.

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As Hurricane Maria ripped through Puerto Rico, she slammed manufacturing plants of a company called Baxter International Inc. on the island. The effects crippled the supply of certain IV fluid bags.

"The shortages are affecting some of the very large bags up to three liters that we use to irrigate during surgical procedures as well as down to little bags which we use for medications. They actually put the medications in those little bags along with the regular saline or whatever they're using to help patients," St. Luke's assistant inventory manager Bill Whiting said.

This is on top of already-existing production issues with other big manufacturers, experts say.

"Production issues and those hurricanes have really created a perfect storm that every health system in the United States is weathering right now," Whiting added.

Saint Alphonsus and St. Luke's say they are mainly suffering from a shortage of the smaller volume bags used to give IV medication that must be diluted before it can be administered to a patient.

"That's traditionally what we've done. Not being able to receive the supply of those that we've needed we've had to change the method in which we deliver those medications," Saint Alphonsus Assistant Vice President of Professional Services and Regional Director of Pharmacy Mark Phillips said.

But they've had to find an alternative.

"With the shortage of some of these bags what we've had to do is do what the pharmacy would call compounding. So they can actually get the solution - sterile water or saline solution - and mix those themselves for those patients. So instead of using the bags they can mix those medications into a syringe or those types of things to help those patients," Whiting said.

"We're now putting those medications in syringes that we fill with saline and the medication," Phillips added.

But only the pharmacy can do that.

"Which is problematic. When we go through nearly about 600,000 bags a year just on some of these problem items, it creates a lot of effort and a lot of work for the pharmacy," Whiting said.

"It just takes more time and resources. We've had to increase staffing within the pharmacy to do the compounding necessary," Phillips said.

With the widespread increase in hospitalizations because of the flu in Idaho and across the country, there's an even higher demand.

"We have seen an increase in flu, which is consistent across the nation. But we haven't really seen how that's impacting the shortage of IV fluids or medication," Phillips said of Saint Alphonsus.

While they're feeling the strain, local hospitals say it isn't impacting patient care.

But, Whiting says St. Luke's expects to spend a lot more this year on fluids.

"St. Luke's will spend nearly $2 million just on saline solutions over a year. And it's kind of a perfect storm so with contract costs we pay for solutions and having to just really get the product no matter what the cost is, we expect to spend significantly more just to make sure we have enough for our patients."

Whiting says he expects the effects of the shortage to last at least another three months as major suppliers recover from production-related or weather-related issues.