Amid a global shortage of epidural catheters, Newfoundland and Labrador's largest health-care authority says it's developing a plan to reduce the impact on patients about to undergo surgery.
In a statement to CBC on Monday, Eastern Health said supply chain problems are the reason for the shortage of epidural catheters, which are best known for being used for pain control during childbirth. The catheters, though, are used for other surgeries, as well.
Eastern Health said it has developed guidelines to help practitioners prioritize the use of epidural catheters and stabilize current supply levels.
Dr. Dolores McKeen, president of the Canadian Anesthesiologists' Society and vice-dean of Memorial University's school of medicine, said patients who are high risk will be prioritized.
"We are absolutely committed that those women will receive other forms of labour analgesia and we are committed to try to make the birthing experience as painless and as comfortable for women as we can," McKeen said.
The guidelines are the result of a collaboration among anesthesiologists and Eastern Health's clinical experts in surgical services and children and women's health. Eastern Health said the guidelines are based on "obstetrical risk factors for patient safety."
The health authority said decisions will be made with the patient's health-care team to cover all considerations.
Patients might not qualify for epidural
Some patients might not qualify for epidural pain control now, said Eastern Health, and low-risk patients who do not meet the criteria to receive an epidural have other options.
While McKeen said epidural catheters are considered the gold standard for pain control during childbirth, there are safe alternatives.
"I think that's the most important thing that I think women should know: that they will not be left without anything, that we will absolutely provide the best care that we can."
Other safe and effective methods of pain control include medications delivered intravenously, through the spine, or through inhalation (often referred to as "laughing gas"), or through breathing and positioning techniques.
Hopefully a short-lived problem: McKeen
McKeen said other countries, including Australia and the United States, have also been impacted by the epidural catheter shortage.
"But in speaking to manufacturers, we are hoping that it will be a short-lived problem. We are trying to get a handle on the shortage and trying to figure out strategies to increase supply into Canada from our manufacturers."
WATCH | Here's how a global shortage of catheters is affecting surgeries in eastern Newfoundland:
Other centres in Canada may have more supply, she said, and others are triaging. Each health authority is using their own algorithm to determine how many catheters need to be kept in reserve, she said.
"Anesthesiologists and health-care authorities are really working a little bit blindly in terms of when we are going to get restock," said McKeen. "And I think that is one of the biggest factors that determines the protocol and the triaging."