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Dialysis Patient Needs In A Disaster

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Title: Dialysis Patient Needs In A Disaster


1
Dialysis Patient Needs In A Disaster
2
  • CMS Disclaimer This presentation was developed
    by Northwest Renal Network while under contract
    with the Centers for Medicare and Medicaid
    Services, Baltimore, MD, contract
    HHSM-500-2006-NW016C. The contents presented do
    not necessarily reflect CMS Policy.
  • Lynda Ball, QI Director,
  • Northwest Renal Network
  • Jim Curtis, QI Consultant,
  • ESRD Network 16

3
What is Dialysis?
  • Dialysis is a medical treatment for people who
    have kidney failure.
  • Dialysis patients come into a dialysis center
    three times a week to have the impurities cleaned
    out of the blood stream.
  • Large needles are placed in a special access in
    the patients arm. Blood is pumped out of their
    body, cleaned, and then pumped back in.

4
Dialysis Facilities
  • Dialysis facilities are very dependent on
    electricity and water for their operations. They
    cannot operate without the required utilities.
  • The nurses and technicians that perform the
    dialysis treatment have had specialized training.

5
Facility Disaster Preparation
  • Develop individual facility disaster plan
  • Build relationship with utility representatives
  • Build relationship with local disaster planners
  • Educate the staff and patients on disaster plan

6
Facility Disaster Preparation
  • Secure the dialysis facility
  • Secure equipment to minimize potential harm to
    persons or property
  • Secure medical records
  • Secure business records

7
Emergency evacuation
  • Clamp and Cut procedure to get off the dialysis
    machine quickly (leaves about 1 cup of blood
    behind)
  • Designated gathering place
  • Emergency evacuation box should have needed
    supplies for removing needles, etc.

8
The Patient Connection to the Dialysis Unit
  • Patients receive life sustaining treatment
  • Spend a minimum of 15 hours a week at the
    dialysis unit
  • Have a close connection to staff and other
    patients
  • Feel the unit is a home away from home

9
Home Dialysis Patients
  • Home hemodialysis patients have treatment at
    their homes 3 to 6 times per week
  • Difficult to take a hemodialysis machine and
    supplies with them in an evacuation
  • Will have the same needs as a hemodialysis clinic
    patient

10
Home Dialysis Patients
  • Peritoneal dialysis patients perform treatment at
    home
  • Can be done away from home
  • Some patients will be able to take supplies with
    them and perform treatments away from home
  • Greatest need will be a continuing source of
    supplies

11
Dialysis is a Necessity not an Option
  • Patients will become critically ill and perish
    without treatment
  • This is basic life support that becomes more
    important than anything else during a disaster

12
Patient Concerns if Treatment is Interrupted by a
Disaster
  • Heightened sense of fear and confusion
  • May be physically weak, dizzy, disoriented
  • May have just begun treatment at time of disaster
    and will be concerned about next treatment

13
Issues in Disasters
  • Many dialysis facilities may be inoperable
  • Patients can be scattered in the evacuation.
  • Utilities and supplies can be scarce
  • Local communication can be disrupted.

14
Needs of Patients in a Regional Disaster
  • Priority will be to find and receive treatment
  • Patients should have some disaster preparation
  • As a group, they will be weaker and sicker than
    the average person

15
Patient Disaster Preparation
  • Patients should be provided educational guides on
    surviving a disaster, such as those created by
    CMS and the National Kidney Foundation
  • The information in these manuals is general and
    will not work for every patient in every
    situation
  • Information includes Preparing for an emergency,
    gathering important medical info, alternative
    arrangements for treatment, emergency supplies,
    diet, disinfecting water
  • Dialysis providers should provide additional
    patient education regarding their emergency plan

16
Patient Disaster Preparation
  • Unless they are told to evacuate, patients are
    instructed to stay at home as long as it is safe
    to do so
  • Patients should take emergency supplies with
    them, as listed in these manuals
  • Start the emergency/disaster diet (sometimes
    called the three day diet) immediately
  • If patients must go to a shelter, to inform the
    person in charge of their special needs

17
Dialysis Patient Special Needs During a Disaster
  • INFORMATION!
  • Greatest fear will be where and when will they
    receive treatment
  • Will want to know who is in charge
  • Will need to be reassured that their needs are
    understood

18
Dialysis Patient Special Needs During a Disaster
- Diet
  • Special diet reduces protein and potassium
  • Sodium restriction is very important
  • Patient disaster manuals have detailed meal plans
    included

19
Dialysis Patient Special Needs During a Disaster
Fluid Restriction
  • Fluid Restriction will be a primary concern in
    patient survival
  • Fluid overload is a major threat to health that
    will lead to death if dialysis treatment is not
    received
  • Fluid intake guidelines are included in the
    patient survival manuals

20
Thank You! Questions?
21
Links
  • www.esrdncc.org
  • www.kidney.org/help
  • www.kcercoalition.com
  • Special Thanks to ESRD Network 16
  • for Developing This Resource!
  • www.nwrenalnetwork.org
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