This publication was developed under Contract Number HHSM-500-2013-NW002C, titled “End Stage Renal Disease Network Coordinating Center (ESRD NCC)", sponsored by the Centers for Medicare & Medicaid Services (CMS), Department of Health and Human Services. The contents presented do not necessarily reflect CMS policy.
As a health care professional, you have a strong relationship with your end-stage renal disease patients and a unique opportunity to help ensure that they are optimally prepared and safe during an emergency. Being prepared prevents chaos, uncertainty, and panic. Emergency preparedness also helps to ensure that patients, their families, and their caretakers implement a coordinated plan to remain safe throughout an emergency and have access to trusted sources of information. With this in mind, the Kidney Community Emergency Response program team has outlined the following tips and reminders to help you and your patients be prepared for any emergency.
1. Take steps to prepare yourself, your family, and your workplace. Before you can help your patients, you must be prepared. If you are not ready for an emergency situation, you will not be able to continue treating your patients.
2. It is important that you make patients aware of their emergency preparedness needs. In order to prepare for an emergency, patients must plan ahead. Patients should work together with everyone in their home to make a plan. Once this plan is in place, patients and their families/caretakers should practice the plan to make sure they all know what to do and how to communicate with one another. Patients should pick two places to meet up with their loved ones in case they get separated in an emergency. One location should be outside their home and another outside their neighborhood. If patients are forced to leave their homes in an emergency, they should take with them their emergency plans, contact information, and other items they may need. Patients and their families/caretakers should also identify an out-of-state friend or relative who they can contact in an emergency.
3. Tell patients to pack a 'go bag.' A “go bag” contains items that are necessary for patients to have with them in the event that they have to leave their homes. The items in the bag should last at least three to seven days and the bag itself should be sturdy and easy to carry or wheel. It should also be ready at any time and located in a spot they can easily access if they are leaving their home in a hurry.
Patients should pack a 'go bag' that includes:
- Copies of important documents in a waterproof and portable container
- Extra set of car and house keys
- Credit and ATM cards as well as cash in small bills
- Bottled water and nonperishable food such as granola bars
- Battery-operated AM/FM radio and extra batteries
- A list of the medications each member of the patient’s household takes, why they take them, and their dosages
- First aid kit
- Contact and meeting place information for the household
- Child care supplies, pet supplies, or other special care items
- Appropriate clothing and shoes
- Dialysis treatment prescription
- Medication list
- Dialysis facility contact information
- Medical equipment
4. Remind patients of their emergency diet restrictions. Make sure they know to:
- Restrict fluids further
- Incorporate phosphate binders into fluid allowance
- Chew gum for thirst
- Avoid table salt and salt substitutes
- Limit fresh fruit and vegetables
- Avoid fruits and vegetables high in potassium, including apricots, bananas, dates, honeydew melon, kiwi, nectarines, oranges, orange juice, prune juice, prunes, and raisins. High potassium vegetables include artichokes, avocados, fresh beets, Brussels sprouts, chard, “greens” (beet, collard, and mustard), okra, parsnips, potatoes, pumpkin, rutabagas, spinach, sweet potatoes, tomatoes and tomato sauce, winter squash, and yams.
- Avoid foods such as bran, dried beans, dried peas, nuts, potato chips, soy or nut milk, and yogurt.
5. Inform your patients of the emergency plan for the dialysis facility. Patients must know what to do, where to go, and whom to contact. They should know the phone numbers of their dialysis facility and doctors. Patients should ensure that facilities have current contact information in case they need to give treatment at an alternate location. If the patient does’t have a phone, they should provide the facility with an alternate person with a phone number so the patient can receive current information. Patients should also know how to safely disconnect themselves from the dialysis machine if it becomes necessary and if they are able to.
Your goal as a health care provider is to do everything you can to protect your patients. You want to help them protect their health and their ability to get care. By following these five simple steps, you can be assured that your patients will be better equipped in the event of a disaster.
For more information about how you can better prepare yourself and your patients, visit http://kcercoalition.com/ .