Hospitals across the United States are reeling from a shortage of IV fluids after Hurricane Helene struck a major manufacturing plant in North Carolina, prompting some to postpone elective surgeries and others to conserve supply by restricting use.

The Food and Drug Administration formally declared a shortage for three fluid products Friday, allowing some hospitals and facilities to manufacture their own supply. The FDA last week had allowed shipments of IV fluids from other countries. But complications make it difficult to immediately end the shortage.

Compounding the issue, facilities that typically don’t manufacture IV fluids need access to sterile water and supplies such as bags to make their own products. The American Hospital Association estimates less than a fifth of hospitals are able to do so.

“If you turn off a hospital supply of IV fluids, it’s like turning off the water supply to your house,” Chris DeRienzo, the hospital association’s chief physician executive, said. “We need to have a continuous, consistent flow to the hospitals, especially as we are walking into the winter respiratory virus season.”

More than 86 percent of health care providers nationwide are experiencing an IV fluid shortage in the aftermath of Hurricane Helene, according to a survey of more than 250 providers released Thursday by Premier, a heath care technology and supply chain company.

Nearly 17 percent of respondents had canceled elective surgeries and another 58 percent were considering doing so in the near term.

The shortage resulted from flooding at Baxter International’s North Cove manufacturing site when Hurricane Helen caused unprecedented rain and storm surges in western North Carolina. These fluids are used to keep sick people hydrated, for dialysis patients and for surgeries, among other purposes. Baxter makes 60 percent of the IV fluid supply used in the United States.

Baxter, in a Monday statement, said it would have 3,000 people on-site this week working on recovery operations at the plant. The company said its goal is to restart operations in phases and to return to allocating 90 to 100 percent of some products by the end of the year.

A temporary bridge constructed in the area helped transport 350 truckloads of products, the company said, and another bridge is being installed.

The company said it is working with the FDA to authorize imports from other Baxter manufacturing sites abroad after the agency approved temporary shipments from five facilities in Canada, China, Ireland and the United Kingdom last week. The primary sources of additional supply of IV fluids will be the large manufacturing sites overseas, according to a senior administration official Monday who spoke on the condition of anonymity because they were not authorized to speak publicly.

Michael Felberbaum, an FDA spokesman, said the agency has taken several steps to help address the shortage as quickly as possible, such as working with manufacturers to increase supply and issuing guidance for compounding pharmacies to help fill the gap.

For more than two weeks, hospitals and health systems have been implementing protocols in an attempt to conserve the nation’s supply of IV fluids. This includes keeping partially used IV fluid bags when a patient is moved within a hospital instead of discarding it, shifting to oral hydration for some patients with water, Gatorade or Pedialyte and assessing patients to ensure an IV is medically necessary before hanging the bag.

Duke University Hospital has been scrutinizing each use of IV fluids since the hurricane struck and expects to continue doing so in the weeks ahead.

“This is such a commonly available fluid that health care probably takes for granted its availability,” said Jonathan Bae, the hospital’s chief quality officer.

Not all hospitals are seeing their supply heavily impacted. But Premier is recommending they all take steps to help conserve the products.

“It’s very similar to the messaging that we used during the pandemic where regardless of whether or not you were in a hotspot, you needed to conserve available supply in order to do what was in the best interest nationally,” Soumi Saha, Premier’s senior vice president of government affairs, said.

Northwell Health, New York’s largest health system, said in a statement it receives IV solutions from a different manufacturing plant but is reviewing all fluid orders during patient rounds to help conserve supply for other hospitals now turning to alternate manufacturers.

Mass General Brigham, the largest health system in Massachusetts, is delaying some elective procedures that rely on IV fluids until at least Wednesday.

The shortage also affects irrigation fluids, which go into cavities such as joints and bladders during operations to prevent infections.

Reid Adams, chief medical officer for the University of Virginia Health University Medical Center, said the hospital is mostly running at normal operations, but must limit procedures using high volumes of irrigation fluids. It has enough fluids for emergency operations and cancer surgeries, but the hospital is postponing some urological and joint procedures that are not considered time sensitive.

“Those are the difficult choices we are having to make,” Adams said.

Hospitals generally keep roughly a week’s supply of IV fluids on hand, said Chip Kahn, the chief executive of the Federation of American Hospitals, which represents for-profit facilities. That’s in part because facilities want to ensure they use all of their supply and that the medications are fresh.

The hurricanes’ impact is sparking a broader discussion of how the federal government and health systems can avoid future disruptions in the supply chain.

“A lot of time and effort is going to be put into thinking through how you anticipate these problems or at least anticipate ways to solve them,” Kahn said.