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Dialysis Patient Needs In A Disaster

Dialysis Patient Needs In A Disaster.

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Dialysis Patient Needs In A Disaster

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  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 patient’s 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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