Preparing for Emergencies: A Step-by-Step Guide for People on Dialysis

prepare for emergencies - A Step-by-Step Guide for People on Dialysis

Step 1
Gather and Carry Important Medical Information

If you must go to a different dialysis center or hospital for treatment during an emergency or travel, or if you need emergency health care, the medical staff need to know your medical status so you can get the right treatment. When your kidneys don’t work, your body processes medicines differently. You must also reduce your fluid intake. Keeping medical staff aware of your medical status helps protect you from getting treatment that could be harmful to you. Keep your medical information with you at all times. You may also want to give a copy to a caregiver or family member.

To help you keep this important information handy, a medical history form is available as a separate document on our website. Fill it out and keep it with you at all times.

Step 2
Make Alternative Arrangements For Your Treatment

If you get in-center hemodialysis:

  •     Make sure your dialysis center has your current street address and phone number in case they need to contact you.
  •     Make arrangements for backup transportation to your dialysis facility.
  •     Get information about other dialysis facilities in your area. Find out if they provide the type of treatment you need. Contact the facility to be sure they can treat you if an emergency occurs and you cannot use your regular facility.

If you get home hemodialysis:

  •     Contact your water and power company ahead of time to register for special priority to restore your lost services.  Keep their phone numbers up-to-date and easy to find.
  •     Keep a flashlight and batteries near your dialysis machine.

If you use chronic ambulatory peritoneal dialysis (CAPD):

  •     If you use an ultraviolet device, keep the battery charged at all times. The battery pack should last for three days.
  •      Keep a 5-7 day supply of peritoneal dialysis supplies at home. Check expiration dates and replace as needed or every six months.

If you use continuous cyclic peritoneal dialysis (CCPD):

  •     If you use a cycler, you may want to purchase a gasoline powered generator that makes 110 volt AC alternating current. Or, if you have a car, you can run your cycler off the cigarette lighter by using a 12 volt DC to a 110 volt AC invertor (available at electronics stores). If the car is in a garage, make sure there is plenty of fresh air and good ventilation.
  •     If you learn how to do manual CAPD, you will not need a generator or invertor. If you lose power and don’t have a generator, switch from CCPD to manual CAPD.
  •     Keep a 5-7 day supply of CCPD (and CAPD if you have learned to do manual CAPD) supplies. Check the expiration dates and replace as needed or every 6 months. If you work outside of your home, keep a 5-7 day supply at work.
  •     Contact your water and power company ahead of time to register for special priority to restore your lost services.  Keep their phone numbers up-to-date and easy to find.

Step 3.
Prepare an Emergency Stock of Supplies, Medicines/Medical Supplies, and Food
Keep your emergency supplies together. You may want to designate a box or some shelves for your emergency supply. Check and restock every six months.

Emergency Supply List
__ measuring cups, teaspoons and tablespoons, dropper
__ plastic knives, spoons, forks
__ pack of napkins and paper plates
__ pack of plastic or styrofoam bowls
__ paper towels
__ pack of plastic cups
__ candles
__ matches
__ can opener (manual)
__ baby wipes
__ sharp knife
__ flashlight & batteries
__ scissors
__ garbage bags
__ plastic jug for storing water
__ 1 small bottle of household chlorine bleach
__ piece of cloth, cheese cloth, or handkerchief
__ strainer
__ extra pair of eye glasses (in case first pair breaks)
__ radio & batteries

Emergency Medication/Medical Supply List
__ first aid kit
__ 5-7 day supply of all your medicine(s)
__ 5-day supply of antibiotics (if you use peritoneal dialysis and recommended by your doctor)
__ Diuretics (fluid pills), sorbitol, and Kayexalate for potassium control (if recommended by your doctor)

Also, if you are diabetic:
__ 5-7 day supply of syringes
__ 5-7 day supply of insulin (Keep cool but do not freeze best kept refrigerated, but will keep at room temperature for up to one month.)
__ 5-7 day supply of glucose monitoring supplies like lancets and alcohol wipes.
__ If you use a glucose meter, have spare batteries and test strips.

If you have heart disease:
__ 5-7 day supply of all blood pressure, heart, or anti-clotting medications.

NOTE: If you use a mail service pharmacy, have them send your medicines a week before you run out. Allow extra time for processing and mailing back to you.  Also, keep a supply of medicine at your work place or any place you spend a great deal of time, like a family member’s home.

Step 4
Know What Emergency Diet* to Follow if Your Dialysis Might be Delayed

Dialysis takes the waste from your blood. Wastes and fluid build up between dialysis treatments. Normally this build up is small and does not cause a problem between regular dialysis treatments. If your dialysis must be delayed, these wastes and fluids can add up and cause problems. To keep the build-up of protein wastes (BUN), potassium, and fluid as small as possible, you need to follow a special strict diet.

This diet plan is not a substitute for dialysis. (*3-day Emergency Diet Plan is available on our website as a separate document.)

The 3-Day Emergency Diet Plan (developed by the Northern California Council on Renal Nutrition) limits your protein (meat, fish, poultry, and egg), your potassium (fruits and vegetables), salt, and fluid intake more strictly than your regular renal diet. This diet provides about 40 grams of protein, 1,500 milligrams (mg) of sodium, and 1,500 mg of potassium per day.

If you can’t get dialysis, your life can depend on limiting the amount of waste that builds up in your blood by changing your diet. Look at this diet plan with your renal dietician to see if it will work for you, or to see if it needs to be modified to fit your special health needs. This gives you a chance to ask questions before an emergency occurs. If you are on CAPD and can’t get to your supplies to do your exchanges, this emergency diet may also apply to you.

You should make every attempt to get dialysis within 3 days. But if it takes longer, be sure to continue the 3-Day Emergency Diet Plan until you can get your dialysis treatment.

The meals can be stored and prepared with little or no refrigeration. If your refrigerator is still working, use fresh milk, meat, and poultry in the amounts listed in the diet.  Your food may stay fresh for a few days if your refrigerator is not working if you limit the times you open its door. Use the fresh food first, before you start to use the canned food.

Information obtained from The Centers for Medicare & Medicaid Services (CMS) booklet “Preparing for Emergencies: A Guide for People on Dialysis.” Go to this link for the full guide: http://www.rsnhope.com/resources/emergency_preparedness_information.php

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