Sunday, November 11, 2012

Are Nephrologists and their patients ready for Natural Disasters?

As the world witnessed a major hurricane on the north east coast of USA last few weeks, were most dialysis facilities ready for such a disaster? Most dialysis patients are not prepared to effectively handle man made or natural disasters as suggested by a study done by UNC Chapel hill in 2011. This was based on a survey and they found that all dialysis centers had a disaster preparedness program in place, but most patients were not well-prepared for a disaster, only 43% of patients knew of alternative dialysis centers and 42% had adequate medical records at home that they could take with them in short notice. Only 40% had discussed the possibility of staying with a friend or relative during a disaster. Only 15% had a medical bracelet or necklace they could wear if they were forced to leave their homes. Age, gender, race, education, literacy, and income did not affect disaster preparedness. 
Following hurricane Katrina, the hospitalization rates of dialysis patients had increased. This might be a similar trend that was likely observed in hurricane Sandy. While certain hospital shut downs happened in NYC, there has to have been increased hospitalizations and transfers to other dialysis units. Such situation add to the patient's stress and misery of their disease burden. 
Fukagawa also discusses what nephrologists might be able to offer to their patients in natural disaster such as earthquakes.  A diary of a nephrologist during the recent Japan earthquake is worth a read. Crush injuries are not uncommon in such disasters and recommendations are present for that as well. Some novel innnovation have also been issued to help in such situations. 
In weather related emergencies, the nursing supervisors and dialysis nursing staff have exemplified their role and leadership. Most of the literature on disaster preparedness comes from the nursing literature. As a nephrology community, we need to be more aware and prepare our patients for weather related emergencies. 


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