Transport of End Stage Renal Disease Patients During Disaster Situations

What Senate Bill does the ESRD disaster transport policy address compliance with?

Senate Bill 1876

What does Senate Bill 1876 address regarding ESRD patients?

The transport of end-stage renal disease patients requiring dialysis during a disaster

Under Health and Safety Code Section 773.112, what must EMS directors approve protocols for?

Protocols giving preference to the emergency transfer of a dialysis patient from the patient's location directly to an outpatient end-stage renal disease facility during a declared disaster

Who can declare a disaster for the purposes of this policy?

The President of the United States

Who else can declare a disaster for the purposes of this policy?

The Governor

During a disaster declaration, where should ESRD patients requiring dialysis preferentially be transported?

Outpatient dialysis centers

What symptom should be assessed as possibly different from the patient's typical pre-dialysis complaints?

Mild shortness of breath

What other symptom should be assessed as possibly different from the patient's typical pre-dialysis complaints?

Weight gain

What other symptom should be assessed as possibly different from the patient's typical pre-dialysis complaints?

Back pain

What other symptom should be assessed as possibly different from the patient's typical pre-dialysis complaints?

Fatigue

What hemodynamic dialysis schedule options should be determined for the patient?

Monday/Wednesday/Friday, Tuesday/Thursday, or Intermittent

What patient preference should be determined regarding transport during a disaster?

Whether the patient would prefer transport to an outpatient dialysis facility

What should EMS screen for before considering outpatient dialysis transport?

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

What should be done if acute illness is identified in an ESRD patient during a disaster?

Recommend appropriate treatment and transport to an appropriate approved emergency department

What should be done if symptoms are absent or mild and consistent with the patient's usual pre-dialysis symptoms and the patient wants outpatient transport?

Contact Medical Control to determine availability of outpatient hemodialysis

What determines priority in destination determination for ESRD patients during a disaster?

Appropriateness per the above screening and patient consent

What must be done after transporting the ESRD patient to the outpatient hemodialysis facility?

Contact the facility and attempt to give them a brief patient report

What minimum credential must sign for the patient at the outpatient dialysis facility?

A minimum of an RN

What must be done once the ESRD disaster transport call is complete?

Notify the EMS Coordinator of the transport destination and complete the ePCR as required in the approved protocols