Disaster Preparedness for Dialysis Patients

Early Dialysis and Adverse Outcomes After Hurricane Sandy

“…13,17 Facility preparedness is also critical. 10,18 Many of the dialysis facilities in the Sandy-affected region had conducted facility-specific risk assessments and had established emergency plans and alternative energy sources (eg, back-up generators). 11,14 All these activities better enabled them to rapidly activate and operate their emergency plans, prioritize and contact patients, and coordinate the surge in early dialysis prior to Hurricane Sandy's landfall.…”

“…[1][2][3][4] Patients with end-stage renal disease (ESRD) are particularly at risk during disasters. [1][2][3][4][5][6] Studies following Hurricane Katrina identified a number of adverse outcomes for dialysis patients, including increased hospitalizations. 7,8 Since that time, considerable progress has been made in emergency preparedness for dialysisdependent patients.…”

“…9 Dialysis facilities commonly have practices in place to facilitate access to urgent dialysis care in times of crisis, including directing patients to facilities that remain open, use of shorter dialysis treatments to accommodate more patients, remain open for a third shift, and in some cases will operate 24 hours a day using staff from other facilities to ensure that additional patients affected by the emergency can receive timely dialysis. [9][10][11] The Kidney Community Emergency Response (KCER) Coalition, formed in response to Hurricane Katrina, routinely activates during potential disasters to assist ESRD Networks in identifying and connecting patients to facilities at which they can receive dialysis if their usual source of dialysis is not available. 12,13 Additionally, some dialysis providers seek to provide dialysis ahead of a scheduled visit, also known as "early dialysis," so patients will not have to miss a dialysis session if a major storm or hurricane disrupts electricity or transportation in a given area.…”

The Impact of a Large-Scale Power Outage on Hemodialysis Center Operations

“…19 While dialysis centers are required to devise and implement emergency plans for patients and their facilities as per the US Medicare Conditions for Coverage, 22 backup power is not an explicit requirement. 19 While dialysis centers are required to devise and implement emergency plans for patients and their facilities as per the US Medicare Conditions for Coverage, 22 backup power is not an explicit requirement.…”

“…2 Emergency preparedness planning by hemodialysis centers, providers, and patients can help decrease interruptions in care and may decrease adverse outcomes in this population during and in the aftermath of such events. 3 Prior studies have demonstrated the challenges of providing hemodialysis in the aftermath of disasters such as hurricanes 4,5 and earthquakes. 3 Prior studies have demonstrated the challenges of providing hemodialysis in the aftermath of disasters such as hurricanes 4,5 and earthquakes.…”