Estimated reading time: 7 minutes
During last year’s saline shortage crisis, Newcastle vet Dr Felicity Cole devised a plan to address the problem. That solution continues to help clinics across Australia. By John Burfitt
It was Greek philosopher Plato who wrote, ‘Necessity is the mother of invention’, and it was 2024’s worldwide shortage of medical saline, when some vet clinics faced a six-month wait for supplies, that was the necessity demanding fast intervention.
In an unprecedented move, Newcastle vet Dr Felicity Cole took action that not only resolved the shortage within her own clinic but also set the ball rolling to do the same in numerous others across Australia.
While the saline shortage crisis finally ended earlier this year, Dr Cole’s novel solution continues to play a key role in vet clinics and care centres across the country.
Midway through last year, the profession felt the full brunt of the supply chain collapse, leaving many clinics with little recourse but to ration, reuse, and innovate so they could offer basic care to patients.
“We received a letter from our main supplier in July informing us we were not going to get new supplies of saline until January, and so we were faced with six months of no fluids,” Dr Cole, co-owner of Merewether Veterinary Hospital, recalls.
“In those first few weeks, we were reusing fluid bags which had some saline remaining in them, which is not ideal as you can’t guarantee sterility once a bag’s been punctured. But we used our judgement and followed AVA advice on what we could do in order to treat patients.”
Dr Cole and I had a detailed conversation about how what she envisaged could work, and I explained we’d need to ensure that whoever was receiving [partially used saline bags] took full responsibility for correct administration.
Suzanna Juniewicz, Australian Red Cross Lifeblood
Saline is an essential component in treating many common medical conditions. The IV fluid is also particularly vital when treating conditions like sepsis and dehydration as well as during resuscitation, post-anaesthesia care and intensive care.
“It was such a dire situation, vet clinics were calling each other and also GPs’ clinics, desperately trying to find supplies.”
An idea is born
Solving the supply crisis was not top of Dr Cole’s agenda the day she walked into her local Australian Red Cross Lifeblood clinic mid last year to donate blood, something she has done since her student days studying veterinary science at the University of Sydney. In 2024, she also completed a PhD in veterinary epidemiology.
But it was during that visit last year that Dr Cole hatched a plan that despite initially seeming farfetched, she was determined to pursue.
“Whenever I go into a Lifeblood clinic, I get equipment envy as what they have to work with seems so fancy compared to what we have to work with as vets,” she laughs.
“I sat there and saw every donor hooked up to an IV, and once the donor would finish, having used maybe only half the bag of saline, the rest would get heat-sealed and tossed into the bin. Perfectly sterile and perfectly usable, and that was when it all clicked; instead of discarding those partially used saline bags, could they instead be donated to veterinary clinics?”
Turning her inspired idea into reality required collaboration between her clinic and Lifeblood. Within days, Dr Cole wrote to Australian Red Cross Lifeblood with a proposal to consider saving leftover IV fluids and donating them to her Merewether clinic.
“Protocols must, of course, be adhered to but I do wonder if we could really start looking into what we consider as medical waste and see what can be used that is safe from contamination and can help us still do our jobs safely.”
Dr Felicity Cole, co-owner, Merewether Veterinary Hospital
“I knew that by heat sealing these sterile products straight away, that would be an opportunity for them to still be usable in a time of crisis—and this was a crisis,” she says.
Making it work
Instead of encountering roadblocks at every turn, Dr Cole recalls every person she encountered at Lifeblood as well as at the AVA saw value in the scheme. “The AVA had already been very proactive and offered a range of guidelines. It then only took days for Lifeblood to respond that they were already looking into the plan, to see if all this could work.”
Lifeblood’s Suzanna Juniewicz was tasked with exploring the viability of handing over the bags of unused saline for veterinary care, which meant carefully scrutinising all the necessary medical and legal logistics involved.
“Dr Cole and I had a detailed conversation about how what she envisaged could work, and I explained we’d need to ensure that whoever was receiving it took full responsibility for correct administration, “Juniewicz explains.
“Dr Felicity agreed the veterinary clinic needed to be responsible and thought that would be seamless as they had many communications regarding alternative options from the AVA.
“We’re always happy to help out wherever we can in our communities, and we have plenty of vets and vet nurses who donate blood to us.”
It was then only a matter of weeks before Dr Cole received a phone call inviting her to pick up the first collection of saline supplies.
“I walked in to pick up the collection that day, and the Lifeblood team handed over a box filled with 20 bags of half a litre each, and I was so thrilled,” she says. “One of the team asked if this would really be enough, and I explained if a cat is only four kilograms, they could be on 200mls a day and so that half litre bag can be very useful.
“That was when it dawned on them that what they had left over could address our supply needs, and also be a good solution to their excess waste.”
With a supply to the Merewether Veterinary Hospital secured, Lifeblood began looking at how the new scheme could be expanded to other in-need clinics across Australia. Within months, they were donating up to 5000 bags of saline to 189 vet clinics and animal centres every month.
Going forward
When the shortage crisis finally eased earlier this year, Dr Cole and her clinic team returned to ordering saline from their regular supplier, but Lifeblood has continued the scheme supplying many other organisations in need, donating to rural animal clinics, RSCPA veterinary hospitals and zoos.
“This is still active, and we are seeing more charitable organisations and animal hospitals who rely on being funded, so this allows them to use their funds on other supplies,” Suzanna Juniewicz says.
“We are always happy to find good homes for product that would otherwise end up in landfill as waste and so we will continue to engage wherever we can as opportunity arises. Other products donated include bandage ends, calcium chews and anti-bacterial solutions where we cannot use them, but animal charities can.”
With the Lifeblood scheme now running effectively, Dr Cole says the veterinary profession has an assured supply in place in case of future shortages. She’s also been in talks with academic colleagues about the possibility of systematically studying how the scheme was established, other ways sectors within various medical communities can support each other in times of need, and ways of tackling the wider issue of waste.
“It would be good to look at where we can cross paths more,” she says. “As the world has modernised, there seems to be less re-use and less sharing of materials because concerns about contamination are critical but also because new materials are so readily available.
“Protocols must, of course, be adhered to but I do wonder if we could really start looking into what we consider as medical waste and see what can be used that is safe from contamination and can help us still do our jobs safely. If we can look at establishing long-term protocols that can safely utilise all aspects of the materials we work with, then that might be a game changer for everyone.”
