Chronic dialysis facilities and patients are usually not included in state and local disaster plans and must therefore plan for their own survival. Because dialysis facilities provide life-sustaining treatment to patients with renal failure, it is imperative that they be as prepared as possible in the event of an emergency. Dialysis facilities should notify the following organizations during their emergency planning phase to ensure external support in the event of a disaster:

• Local/regional emergency planning department
• Local/regional health department
• Local/regional social services department
• Emergency responders (fire, law enforcement, rescue)
• Utility providers (electricity, water, gas, telephone)
• Transportation vendors

Patients should likewise prepare themselves for emergency situations that may prevent them from getting to their dialysis treatment. The information and resources provided below can help facilities and patients get started.


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What We Can Do to Assist You...

MARC can assist individuals and providers/facilities in planning for an emergency or disaster by providing resources and direction to agencies that specialize in emergency planning and response. During emergencies, we will provide the following services:

• Track and make available the open and closed status of facilities in affected areas
• Assist patients and facilities in identifying dialysis facilities that can provide ESRD services.
• Assist family members and treating facilities in determining the dialysis location of displaced patients in order to exchange critical medical information
• Coordinate with providers and emergency workers to ensure patient access to dialysis

Each facility must designate 2 Disaster Contacts and provide their names and at least 2 telephone numbers at which each can be reached during an event. Facility representatives are required to report their open or closed status to the Network office as soon as possible. "Open" facilities are defined as facilities that have potable water, electricity from any source, and supplies and staff sufficient to provide dialysis, and that are performing dialysis. Anything less than this is considered "closed."

To determine the open or closed status of a dialysis facility in an impacted area and the services being provided, or to get a map showing the nearest open facility in the event of an emergency or disaster, go to http://dialysisunits.com.

Following an emergency event, facilities are required to report patient movement (including transient patients dialyzing in your unit) using the Disaster Patient Activity Report (DPAR). This report should be submitted to the Network office on Day 5 post-event, and then twice weekly (Tuesday and Friday) until notified.

If MARC is impacted by an event, another ESRD Network will be designated to assist you. To find out which ESRD Network has been designated to assist in your state, call the Network 5 office at (804) 794-3757.

The KCER Coalition has developed a standardized emergency data set that facilities should produce and distribute to patients on at least a quarterly basis. This data set includes the patient's name, address, emergency contacts' information, home dialysis unit information, treatment information, and medications, and patients should be instructed to carry the information with them at all times in case they are displaced by an emergency event and must dialyze at a different facility.

MARC is part of the National Kidney Community Emergency Response (KCER) Coalition, which has developed a number of tools and resources to assist providers, federal, state, and local emergency responders, patients, and patients' families in establishing emergency preparedness and response plans. Below are links to a number of resources created by the Coalition, as well as additional materials to assist facilities and patients in preparing for emergencies.


State Health & Emergency Management Agencies...

Virginia Department of Health's Emergency Preparedness & Response Programs
Virginia Department of Emergency Management

Maryland Department of Health & Mental Hygiene
Maryland Emergency Management Agency Prepardeness Information

West Virginia Department of Health & Human Resources' Health Preparedness
West Virginia Division of Homeland Security & Emergency Management

District of Columbia Department of Health
District of Columbia Emergency Management Agency


For Patients...

Resources for coping with disasters *NEW* (from MedlinePlus, a service of the U.S. National Library of Medicine and the National Institutes of Health)

Preparing for Emergencies: A Guide for People on Dialysis (PDF) Each new dialysis patient receives a copy of this helpful booklet, which contains information on gathering and carrying important medical information, making alternative arrangements for treatment, and what diet to follow if dialysis must be delayed during an emergency. This guide was published by the Centers for Medicare and Medicaid Services. A Spanish version (PDF) is also available.

Planning for Natural Disasters and Other Types of Emergencies (PDF) This publication, produced by the National Kidney Foundation and the TransPacific Renal Network, is a guide for both dialysis facilities and patients preparing for emergencies.

Save a Life - What You Need to Know about Emergency Preparedness for Individuals with Kidney Disease (courtesy of the Coalition) (PDF) This document explains what is required in order to provide dialysis treatments, as well as what providers, patients, and emergency responders should do to prepare and provide for dialysis patients during an emergency.

Key Information to Help Individuals with Kidney Failure during an Emergency or Disaster (courtesy of the Coalition) (PDF) This 1-page document has contact information and links to a variety of important services, including the ESRD Networks, how to obtain the status of dialysis facilities, where to register as or find volunteer staff, assistance for transplant patients, and information on available supplies, equipment, and medications.

The Nephron Information Center has an extensive website dedicated to disaster preparedness for kidney patients and their providers, including an evacuee emergency data form that can be downloaded, completed, and taken with patients to other dialysis facilities.

Hurricane Information for Evacuees & Other Affected Persons (from the Centers for Disease Control & Prevention) Information that can be applied to hurricanes as well as other disasters.

Index of Printable Disaster Materials (from the Centers for Disease Control & Prevention) This list includes a number of safety and recovery publications that can be downloaded in as many as 8 different languages.

Canned Food: How Long Can You Safely Keep It? (from the Mayo Clinic) Commercially prepared canned food has a fairly long shelf life.

Managing Diabetes during a Disaster: 6 Steps to Safety (from the Mayo Clinic) Managing diabetes during a disaster requires careful planning. Start preparing now.

Reference Guide to Water System Emergencies (from the Virginia Beach Department of Public Utilities) Critical Care Facilities newsletter to assist facilities and patients in preparing an emergency water supply plan.


For Dialysis Providers...

Resources for coping with disasters *NEW* (from MedlinePlus, a service of the U.S. National Library of Medicine and the National Institutes of Health)

Adapting Standards of Care under Extreme Conditions *NEW* Download this FREE guide, published by the American Nurses Association, for information on ethics and standards that apply to making decisions about care during extreme or unusual circumstances, such as emergencies, disasters, and pandemics.

Sign up to receive email updates from the CDC! Complete a subscription profile, and you will get updated information on the items of interest to you, including emergency preparedness and response.

Emergency Preparedness for Dialysis Facilities (PDF) This publication was prepared by the Centers for Medicare & Medicaid Services to assist dialysis facilities in the mitigation, preparation, response, and recovery associated with an emergency situation. It helps facilities to ensure the safety of employees and patients, assure the availability of dialysis care, protect medical and business records, mitigate property and content damage, and return to normal operations as soon as possible.

Planning for Natural Disasters and Other Types of Emergencies (PDF) This publication, produced by the National Kidney Foundation and the TransPacific Renal Network, is a guide for both dialysis facilities and patients preparing for emergencies.

In October 2001, the American Nephrology Nurses Association published a "Disaster Preparedness" issue of the Nephrology Nursing Journal. Below are links to some of the articles it contained:

• Disaster Preparedness: Is Your Unit Ready? (PDF) by Caroline Counts, MSN, RN, CNN
• Emergency Preparedness Guidelines for Water Treatment Systems (PDF) by Rebecca Amata, BSN, RN, CNN
• Proper Planning and Networking are Key in Preparing for Disasters (PDF) by Mary Ann Gould, MSN, RN, CNN
• Surviving a 500-Year Flood (PDF) by Holly Fadness McFarland, MSN, RN, CNN
• Emergency and Disaster Planning: Patient Education and Preparation (PDF) by Elizabeth Howard, RN, CNN, and Karen Wiseman, MSN, RN, CNN
• Emotional Trauma Associated with Renal Disease and Natural Disasters (PDF) by Martha Jean McClellan, MDiv, BA

Extended Care Facility Emergency Response Guidelines (PDF) Guidelines for basic emergency planning, response, and recovery (from the Virginia Department of Health)

Water Safety & Infection Control following a Disaster - for Healthcare (Dialysis) Professionals (from the Centers for Disease Control & Prevention)

Reference Guide to Water System Emergencies (from the Virginia Beach Department of Public Utilities) Critical Care Facilities newsletter to assist facilities and patients in preparing an emergency water supply plan.

Index of Printable Disaster Materials for Healthcare Professionals (from the Centers for Disease Control & Prevention) This list includes a number of safety and recovery publications that can be downloaded in as many as 8 different languages.

Hurricane-related Information for Healthcare Professionals (from the Centers for Disease Control & Prevention) Includes information on immunization, medical records, licensing and legal requirements, infection control, and much more.

Save a Life - What You Need to Know about Emergency Preparedness for Individuals with Kidney Disease (courtesy of the Coalition) (PDF) This document explains what is required in order to provide dialysis treatments, as well as what providers, patients, and emergency responders should do to prepare and provide for dialysis patients during an emergency.

Key Information to Help Individuals with Kidney Failure during an Emergency or Disaster (courtesy of the Coalition) (PDF) This 1-page document has contact information and links to a variety of important services, including the ESRD Networks, how to obtain the status of dialysis facilities, where to register as or find volunteer staff, assistance for transplant patients, and information on available supplies, equipment, and medications.

The Nephron Information Center has an extensive website dedicated to disaster preparedness for kidney patients and their providers, including an evacuee emergency data form that can be downloaded, completed, and taken with patients to other dialysis facilities.

Find or offer volunteer staffing during an emergency.


*Information provided in the above links is subject to change in the event of a disaster.