Policy 5–ESRD Disaster Transport

What law does Policy 5 comply with?

Senate Bill 1876.

What does Policy 5 address?

Transport of end-stage renal disease (ESRD) patients requiring dialysis during a declared disaster.

What must the protocol give preference to during a declared disaster, per Health & Safety Code Section 773.112?

Emergency transfer of a dialysis patient from their location directly to an outpatient ESRD facility.

Who can declare the disaster that triggers this policy?

The President of the United States, or the Governor.

What typical pre-dialysis symptoms should you check for versus new complaints?

Mild shortness of breath, weight gain, back pain, and fatigue.

What should you determine about the patient's dialysis routine?

Their typical hemodynamic dialysis schedule (e.g., Monday/Wednesday/Friday, Tuesday/Thursday, or intermittent).

What should you screen for before deciding on outpatient transport?

Acute illness such as hemodynamic instability, profound dyspnea, fever, or other concerning symptoms.

If acute illness is present, where should the patient go?

Recommend appropriate treatment and transport to an appropriate approved emergency department.

If symptoms are absent/mild and consistent with the patient's usual pre-dialysis symptoms, and the patient wants outpatient care, what should you do?

Contact Medical Control to determine availability of outpatient hemodialysis.

What should be obtained before leaving the outpatient dialysis facility?

A signature from an approved healthcare provider (minimum of an RN).

Who must be notified once the transport is complete?

The EMS Coordinator, and the ePCR must be completed as required.