Anyone on dialysis should be educated on how to proceed in the case of a natural disaster, like an earthquake, that could interrupt hemodialysis situations due to a power outage or water treatment system failure. Patients who are receiving hemodialysis should be taught about how to be prepared for disasters. In the case of an emergency leading to dialysis malfunction, individuals should be aware of the necessary steps to take.
Governments at both the local and national level should plan ahead to meet the demands of responding to emergency situations and ensure the safety of those affected by kidney disasters. There are some areas of the world that are more prone to natural disasters and power outages. Be aware of the disasters that are common where you live. The type of disaster you may expect will help you plan ahead.
Here is an excellent link from the Kidney Foundation: Planning For Emergencies – A Guide For Dialysis Patients
What to know: Hemodialysis Patients
Basic Preparation for Dialysis Patients
Maintenance hemodialysis patients need to know about disaster preparedness. If there is an earthquake or other emergency, it is possible that dialysis treatment may not be available. The electricity might be shut off, and ruined roads and other damage might make it hard to move to a different area.
1) Patients should pack a disaster bag themselves. This bag should feature the phone number of the person’s primary medical provider, the dialysis center, and the telephone number of any other dialysis centers nearby where the patient lives.
2) Patients should pack emergency food. It is essential to have the right kind of rations for an emergency because there is a chance that dialysis will be postponed. If dialysis patients move out of their homes and into a shelter, it is important that those providing care for them be informed about any medical requirements related to the dialysis.
3) Patients should maintain regular contact with their dialysis center, and be aware of the addresses and contact information of other dialysis healthcare facilities in the vicinity.
4) If the dialysis machine experiences a power outage that prevents the surrounding staff from helping, patients should know how to safely detach from the machine without damaging it.
5) It may be beneficial for dialysis patients to have extra potassium exchange resins on hand in case of an emergency, as a way to cope with the aftermath of the disaster.
What to Include in Emergency Food for Dialysis Patients: Dietary Care During Disasters
In the event of a disaster leading to hemodialysis units or dialysis treatment being unavailable or delayed, it’s important to be able to recognize and be ready to adopt a restricted diet in order to keep electrolyte and water levels balanced.
The document “Preparing for Emergencies: A Guide for People on Dialysis” outlines nutritional guidelines during emergency situations for those receiving dialysis.
It is recommended that individuals undergoing dialysis should stay away from foods with a high potassium content, take care when eating fruits (even dried ones) and restrict their consumption of vegetables, including potatoes.
Patients should also reduce the amount of water they consume, as well as their intake of protein, salt, and salt substitutes. Substitutes for salt can be very unsafe as they typically contain a lot of potassium.
In the event of a catastrophe that results in the loss of power, it is wiser to consume food that has been kept cold rather than eat items stored at room temperature. Disaster rations often come in a package and should be stored in a place where it will stay dry and should be inspected for when it will expire and any signs of damage such as leaks. Food that is dry should be placed in a sealed container that stops bugs and humidity from entering.
It is especially critical to restrict water intake when dialysis has to be delayed by patients. Consume no more than half of your typical water intake. Patients who have put on considerable weight between dialysis appointments should cut down their water intake to half the usual quantity. Individuals in need of hydration can satisfy their craving by sucking on hard candy, munching on gum, and repeating mouthwashes.
The Centers for Disease Control and Prevention (CDC) is collaborating with the KCER Coalition to bring you a 3-day emergency diet plan.
Disaster Preparedness for Earthquakes in Hemodialysis Units in Gyeongju and Pohang, South Korea
In this study, we propose a logistical approach for large-scale disasters and an emergency management plan for Korean dialysis centers. The personnel of the district’s HD unit must be aware of the destruction magnitude of the facility in order to be ready for potential water system failure and electricity outage in the event of a massive catastrophe.
It is important for HD facilities to engage in conversations about role-playing prior to the occurrence of any disaster. It is important to choose a local coordination HD unit ahead of time. The regional coordination HD unit is essential in situations of catastrophe; they must contact other accessible HD units to request emergent aid to give hemodialysis. A central coordination HD unit is essential for a regional reaction and needs to sustain its additional capacity to provide dialysis-relevant materials and personnel for unexpected scenarios.
It is important to plan ahead in order to be prepared for potential renal-related disasters at both local and national government levels, as well as each Health Department unit. A subsidy or incentive from the government can be beneficial in setting up protocols to cope with power blackouts, such as having an uninterruptible power supply (UPS) or a back-up generator in place. The cost of the project will go up as more equipment is needed.
It is imperative that the Nephrology Society, the producers of dialysis systems, and those undergoing dialysis treatments pay necessary attention and recognition to the Hospital Management Department, which has the most paramount concern for patient wellbeing. The authorities should also concentrate on international cooperation with the International Society of Nephrology (ISN) for dealing with extreme calamities.
Since the devastating earthquake in Armenia in 1988, the International Society of Nephrology’s Renal Disaster Relief Task Force (RDRTF) was created to assist with nephrologic treatment and quick dialysis for emergency kidney problems resulting from catastrophic events. Authorities should make an effort to provide assistance which will facilitate global collaboration in the event of huge catastrophes.
It is clear that the Korean Peninsula is vulnerable to natural disasters, just like the rest of the Asia-Pacific region. All relevant personnel, such as nephrologists, nurses, technicians with knowledge of dialysis, and dialysis patients, need to receive more instruction in order to handle emergency circumstances effectively. It is necessary to establish a lasting disaster relief program with assistance provided by the governmental and nephrology authorities as well as international organizations. It is imperative that immediate steps are taken to enhance readiness for emergency scenarios in hemodialysis facilities.
READ MORE: Protecting Seniors: The Kidney Failure Crisis
Topic Collection: Dialysis Centers
Disasters can have a great influence on individuals receiving prolonged dialysis treatments. Damage to roads and medical centers can prevent people from getting to their treatment location on time, causing interruptions to their appointments. Catastrophes can also pollute water sources or affect other services. This may interfere with a facility’s capability to give secure dialysis treatments to people under their care. Catastrophes such as earthquakes can give rise to crush injuries that inflict harm on the kidneys, raising the call for hospital-based dialysis treatments.
When catastrophes occur, dialysis centers and medical facilities will require time to bounce back from the repercussions on their offerings. This includes personnel who have been impacted by the disaster and who may be unable to report to their job. This text outlines findings from recent developments, data regarding recuperation for dialysis centers, ways of providing care for dialysis patients after a disaster, and documents, technologies and models that can be tailored for each facility’s needs.
ASPR TRACIE. (2021). Post-Disaster Lessons Learned: Dialysis Patient Management.
ASPR TRACIE has provided outcomes and facts from sources and materials related to post-catastrophe dialysis procedures in reaction to numerous requests for specialist help. A technical solution that was already executed to improve how dialysis patients were managed after Sandy is included for further study.
Centers for Disease Control and Prevention (2018). Dialysis Care After a Disaster.
CDC offers guidance on how to address dialysis care after a disaster, such as connecting the water system again, utilizing “tanker water,” and addressing “boil water advisories.”
Centers for Medicare and Medicaid Services (2011). Disaster Preparedness: A Guide for Chronic Dialysis Facilities. Second Edition.
This manual has a collection of templates that can be customized to the specific requirements of dialysis and end stage renal disease facilities in emergency situations.
Dent, L. (2015). Examining the Development of Emergency Preparedness for Dialysis Treatment Since Hurricane Katrina American Journal of Kidney Diseases. 66(5): 742-744.
The authors have taken a look at how dialysis care has been enhanced between 2005 and 2015, and have urged further steps to increase preparedness. Advice involves informing patients more thoroughly about nutritional requirements during crises; urging patients to keep their dialysis schedules and lists of prescriptions handy; and implementing rules at the state level requiring dialysis centers to have generators as a power source.
Fournier, C. (2011). Re-Establishing Clean Water in a Disaster. (Abstract only.) Nephrology News and Issues. 25(10): 28-9, 34.
The author outlines five steps for dialysis clinics to take in order to ensure the safety and efficiency of their water systems following an emergency event.
Kelman, J., Finne, K., Bogdanov, A., et al. (2015). Dialysis Care and Death Following Hurricane Sandy. American Journal of Kidney Disease. 65(1): 109-15.
The authors of this investigation analyzed changes in the dialysis treatment for people who are at the end of their life regarding kidney failure in both New York City and New Jersey in the aftermath of Hurricane Sandy. Additionally, they looked at the mortality rate in those regions. The researchers talked about their discoveries and decided that the individuals within the experiment group (people who lived in places hit by Sandy) had more ER visits, hospitalizations, and 30-day fatalities than those in the comparison groups.
Kleinpeter, M. A., Norman, L., and Krane, N.K. (2006). Disaster Planning for Peritoneal Dialysis Programs. (Abstract only.) Advances in Peritoneal Dialysis. 22: 124-9.
The authors tell the tale of how a center for peritoneal dialysis managed the Hurricane Katrina situation, from before the storm hit, during its duration, and after the traumatic event had ended.
Kopp, J., Ball, K., Cohen, A., et al. (2007). Planning for Kidney Patients in Emergencies: Preparations for Patients Receiving Dialysis Treatment and Facilities. Clinical Journal of the American Society of Nephrology. 2(4): 825-38.
This article analyzes the medical guidelines for treating patients during a disaster developed by the Kidney Community Emergency Response Coalition. They offer an in-depth look into the procedure for disaster planning from the views of those with kidney ailments, dialysis centers, and voluntary nephrology specialists who might engage in aid during a crisis.
Lempert K. and Kopp, J. (2013). Hurricane Sandy as a Kidney Failure Disaster. American Journal of Kidney Disease. 61(6):865-8.
In this paper, the writers look back on what has been learned from recent catastrophes and present the essential components of disaster planning for kidney failure.
Lurie, N., Finne, K., Worrall, C., et al. (2015). Early Dialysis and Adverse Outcomes After Hurricane Sandy. American Journal of Kidney Diseases. 66(3):507-512.
The writers conducted a look back cohort study to assess the impact of beginning hemodialysis before Hurricane Sandy on patient outcomes in both New York and New Jersey. It was discovered that patients who were given dialysis at the beginning had significantly lower chances of visiting an Emergency Department (20%), being admitted to the hospital (21%), and passing away in the 30 days following the storm (28%).
National Kidney Foundation. (2013). A Guide for Chronic Kidney Disease Patients on Preparing for Emergencies National Kidney Foundation.
The authors present advice for people who have kidney disease to think about when getting ready for different kinds of disasters.
Stoler, G., Johnston, J., Stevenson, J., and Suyama, J. (2013). Creating a Training Program for Emergency Staff in Dialysis: A Quick-Response Plan for More Employees During Emergencies. (Abstract only.) Disaster Medicine and Public Health Preparedness. 7(3): 272-7.
This just-in-time training program is created to enable emergency personnel with limited knowledge about dialysis to offer aid to dialysis staff in an unforeseen event. The authors trialed the curriculum and observed an approximate 30% enhancement in knowledge due to the program.
U.S. Food and Drug Administration. (2018). Reopening Dialysis Clinics After Restoration of Power and Water.
Renal Dialysis Services in the Christchurch Earthquakes of 2010-2011. Renal Society of Australasia Journal. 7(2): 66-68.
Centers for Disease Control and Prevention (2018). Dialysis Care After a Disaster.