Fire Weather Preemptive Power Outages

As an example of new regulations that allow utilities to preemptively shut off power to areas with high temperatures, low humidity, and high winds, Southern California Edison has announced that it may shut off power to parts of the Coachella Valley later this week (July 2-4, 2019); see https://www.sce.com/outage-center/major-outages.  Different regulations apply to different areas, depending on perceived risk, as defined by the California Public Utilities Commission.  You can find a good summary of these issues, including a map of the areas most likely to be impacted, at https://microgridnews.com/california-utilities-plan-power-shutoffs-to-avoid-2019-wildfires/.  While these issues currently apply to California, they may soon also apply to Network 16 states.

Dialysis facilities are already required to be prepared for power outages, though many facilities share backup equipment because outages have been more local in the past.  Facilities will want to review their backup power plans to include preemptive outages and consider whether sharing backup power equipment is still practical when all nearby facilities have also gone dark.  Dialysis facilities with patients on home dialysis modalities, particularly home hemodialysis, will want to assure that all of their patients have access to adequate dialysis even if power is out for a week or more, which could occur if hot, dry, windy weather persists in an area.  Facilities will also want to assure that their home patients are well trained in how to respond to preemptive outages.  The occurrence of preemptive outages is intended to be announced by utilities in advance, but if weather changes rapidly, or individuals are difficult to locate, it may not be possible to notify everyone before the fact, so facilities may want to develop their own phone trees or other strategies, being mindful of HIPAA.

Since dialysis is not the only situation where patients and facilities are vulnerable to preemptive power outages, it may be helpful to coordinate with your county or regional Healthcare Coalition; see https://www.kcercoalition.com/en/resources/professional-resources/cms-emergency-preparedness-rule/state-healthcare-coalitions-list/california-healthcare-coalitions/ for contact information, or check with your county Health Department (Tulare, King, Kern, Orange, and Riverside Counties are absent from the KCER list).  CMS requires all facilities to report to their Network any lapse in the ability of patients to have access to dialysis because of emergency events; for details see https://nwrnbulletins.wordpress.com/2019/06/04/notify-network-of-emergencies/.

A few resources that may be useful for facilities and patients in this context:

ANNA Fact Sheets on PD, AKI

The ANNA Special Practice Networks have published a series of several-page Fact Sheets on a number of topics:

NW18 6/13+ UCLA re PD, Alport, BP, Labs

The UCLA Core Kidney Program has announced three new webinars and a patient-education meeting.  For more information see https://www.uclahealth.org/core-kidney/upcoming-events.

  • July 11, 2019: Alport Syndrome webinar.  Check the uclahealth.org link above in mid-June for registration.
  • July 14, 2019: High Blood Pressure – What You Should Know UKEEP patient-education meeting.  See the uclahealth.org link above for more information and the RSVP phone number.
  • August 8, 2019: Labs – What You Should Know webinar.  Check the uclahealth.org link above in mid-July for registration.

HDC re LOL-HD

MEI’s Home Dialysis Central blog has an interesting post on Laugh Out Load Hemodialysis, which Satellite Dialysis has been experimenting with.  Among other things, the post describes the physiological benefits of laughter, including its positive impact on mood, pain, lungs, cardiovascular function, and immune response.  Find the post at https://homedialysis.org/news-and-research/blog/305-laugh-out-loud-hemodialysis-lol-hd-improving-the-dialysis-experience-at-satellite-healthcare/.  While the subject of the post is in-center dialysis, anyone with an internet connection and computer or smartphone who dialyzes at home can call up a million comedies to watch.  See also https://s3-us-west-2.amazonaws.com/nwrn.org/files/N/DPC/DPCLaugh2019.pdf for information on a May 26, 2019 webinar on Pain Relief through Laughter.