An ongoing shortage of fluids used to deliver medicine and treat dehydrated patients has hospital workers scrambling in the midst of a nasty flu season and supplies from factories in storm-ravaged Puerto Rico have been slow to rebound.

For one Peoria area hospital conglomerate, it has meant some changes; another maintains that its supplies are fine.

Supplies of saline and nutrient solutions were already tight before hurricanes pounded Puerto Rico and cut power to manufacturing plants that make much of the U.S. supply of fluid-filled bags used to deliver sterile solutions to patients.

Flu season has turned out to be a bad one and it came early, bringing patients in need of fluids into hospitals already running low.

Elsewhere around the country, hospital officials, pharmacists and other staff have been devising alternatives and workarounds, training doctors and nurses on new procedures and options, and hitting the phones to try to secure fluids from secondary suppliers.

The U.S. Food and Drug Administration said earlier this month it believes shortages will start to ease over the next few weeks, but stressed “the production situation in Puerto Rico remains fragile.”

Puerto Rico’s power grid is being slowly restored and the last of three Baxter International factories there that make saline bags and nutrient solutions was reconnected just before Christmas. But intermittent power outages are still slowing Baxter’s efforts to get back to full production.

Only a few other companies make those solutions, and supplies never fully recovered after a 2014 shortage of saline bags.

For UnityPoint Health hospitals in the area — Methodist, Proctor and Pekin — there is no concern, spokesman Blake Long said.

"We are aware of the shortage, but we are well stocked and it’s not impacting care for us," he said in an email.

At OSF HealthCare, physicians and nursing and pharmacy staffs have implemented some practice changes. They anticipate the situation continuing for a few more months.

"Our goal is that this is invisible to the patient that we’re able to make practice changes behind the scenes with working with the providers as a team, said Jerry Storm, head of pharmacy operations for OSF, in a video posted on the organization's website.

Where once, practitioners might have kept someone on an IV throughout their treatment, " ... now, if that patient can come off an IV fluid and start taking oral fluids then we will transition them as quickly as possible as long as it’s safe for the patient."

The FDA has been trying to boost supplies, giving two additional companies approval to start selling saline bags, likely within a couple months. It also gave Baxter permission to temporarily import sterile fluids from six overseas factories.

Baxter says it’s been shipping those to U.S. hospitals since October, but some hospital officials around the country say that hasn’t been enough.

Shortages are also hitting surgery centers, cancer clinics that infuse chemotherapy, dialysis centers and companies that provide regular infusions to home-bound patients.