Dialysis during a power outage, what to do, what to expect

We had a big storm here last Thursday. For the last few days, it has been tropically humid (very unusual for Melbourne) and on Thursday, down it came. I arrived at the BigD unit just as the downpour started and I thought I would wait it out. 15 minutes later, I decided to run for it. As a result, I arrived dripping wet from head to foot. For the first time in many years, I dialysed in a classy paper gown, delighting one and all.

About an hour later the thunder and lightning kicked in. It’s always enjoyable to be inside during a storm, feeling safe and protected from the elements. But this time, not quite: bang! A complete blackout. No lighting, no power to the machines, computers, telephones, coffee urn or ice maker. Luckily, it wasn’t yet completely dark, so we could see ok. All machines began alarming, creating a real din, but they also kept running (each has battery backup, which can last between 5 and 15 minutes).

This happens rarely, but it is good to know that there is a safe and simple procedure that your unit will follow when a blackout does occur, so here is a quick overview.

Our unit is quite small, just 8 machines, and all were in use. At any one time each machine has about 250 mls of our blood flowing through the lines. While the loss of that amount of blood is not life threatening, it is also not healthy: it reduces the body’s oxygen-processing capacity and lowers the haemoglobin, which can cause weakness and dizziness at varying levels of severity. Also, it takes at least a few weeks for the body to build the blood volume back up to where it should be.

The only time anyone should lose that much blood on BigD is during an emergency (eg a fire), where it is standard operating procedure to clamp and cut the lines and leave as quickly as possible. (Most units conduct emergency drills twice a year, but without cutting the lines.)

So there we were, everyone connected to a machine and all machines running on battery power. We were alert, but not alarmed – yet.

At this point the unit staff had several options.

  1. Assume the power will come back on within a few minutes and do nothing. If it does, this turns out to be a good option. If it doesn’t, all is not lost: for extreme situations, eg where the batteries fail, each machine also has a hand crank, which can be operated either by staff or the patient, to pump the blood around the lines and back into each patient. (I have done this once. It is slow, but effective.)
  2. Assume the power will come back on within 30-40 minutes, run each patient back under battery power¸ ask them to wait until it comes back on, and when it does, reconnect them and continue the run.
  3. Assume the power will remain off, run each patient back under battery power and send them home, with a (bonus?) reduced treatment time

The option to choose depends on the history of outages in the area and how easy-going or otherwise the patients are.

In our area, blackouts are relatively rare, and often momentary, so the staff chose option 1. It was a good choice. About five minutes later, the power returned, and dialysis continued without a break.

From us patient’s viewpoint, we had a burst of excitement followed by a frisson of potential danger, a short wait, then back to normal.

Power outages are a routine, planned for part of BigD. The worst outcome is that your run will be cut short. So follow staff directions and relax.

Note: If your unit is part of a hospital (ours is a stand-alone unit), in addition to the battery backup in each machine, your unit may have an Uninterrupted Power Supply (UPS) or generator backup, or both. This could extend the available power by several hours or even days. If this is the case, an outage would have little if any impact on your dialysis.

Do you have power outages in your area? Do you do anything different?

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