Climate disaster plans requested for dialysis patients

When catastrophic flooding destroyed a bridge and washed out or cut off highways in southern British Columbia, Mitchell Dyck and other patients regularly requiring life-saving dialysis had to be airlifted to hospital.

Flooding from record rains in November 2021 closed all roads to the rest of Canada and prevented Mitchell Dyck from making the 25-minute drive from his home in Chilliwack to the dialysis unit at the Chilliwack Regional Hospital. Abbotsford.

Mr. Dyck, now 25, was receiving nighttime dialysis three times a week because his kidneys were not filtering waste and excess fluid from his blood due to a genetic disease diagnosed a year earlier. early.

He said a nurse called him and others to tell them they would have to go to the Chilliwack airport to board a helicopter, but the anxious patients ended up right in the middle chaos and he arrived at the hospital just in time for his treatment.

It was a bit worrying, and my family was also worried about whether I would be able to make itDyck recounted of the rush for treatment during a weather disaster that forced nearly 15,000 residents of several communities from their homes and killed five people in a landslide.

While some dialysis patients were housed in hotels, Mitchell Dyck stayed with his grandparents in Abbotsford until portions of Highway 1 opened to traffic two weeks later. After being on dialysis for almost two years, Mr. Dyck underwent a kidney transplant in August 2022 and now takes eight medications, including immunosuppressants and high blood pressure medications, which he always has on hand in case of emergency. ’emergency.

A 2022 study by Environment Canada suggests that climate change has made flooding in British Columbia at least twice as likely and it is possible that similar events will increase as greenhouse gases continue to enter the country. the atmosphere.

The likelihood of further disasters, including wildfires and droughts, has nephrologists calling for better emergency planning across the country to ensure that particularly vulnerable dialysis patients have access to treatment without which kidney failure could lead life-threatening illnesses or even death.

Creation of a working group

Dr. Shaifali Sandal, a transplant nephrologist at the McGill University Health Center in Montreal, is working on a project with the Canadian Society of Nephrology to determine how best to manage kidney patients in the event of a disaster.

She said the Montreal General Hospital treated at least 20 additional dialysis patients last summer after Cree Nation communities in northern Quebec were evacuated due to wildfires.

Our units are already over capacity and we have actually requested help from neighboring units that are not affiliated with us.

As part of the project funded by the Canadian Institutes of Health Research, she will establish a working group to gather feedback from health professionals and patients across the country to understand how to better coordinate care in cases emergency.

Sandal also reviews research papers on lessons learned in other countries in caring for kidney patients during various emergencies.

We want to apply experiences from disasters, including an earthquake that displaced people in Japan, and experiences in Ukraine due to war and climate change emergencies that forced people from their communities

: ”’have a contingency plan, have a communications plan, have a network within your region, so that if you need to accommodate additional patients, you can do so. Have a disaster coordinator in each region.”,”text”:”They say, ‘have an emergency plan, have a communications plan, have a network within your region, so that if you need to accommodate additional patients, you can do so. Have a disaster coordinator in each region.”}}”>They say, ”have a contingency plan, have a communications plan, have a network within your area, so that if you need to accommodate additional patients, you can do so. Have a disaster coordinator in each region”.

Dr. Sandal said BC Renal, a B.C. network that plans and coordinates care for patients with kidney disease, could serve as a model for the rest of Canada because it offers ‘incredible’ resources to help patients to prepare for an emergency.

I think we just need permission from BC Renal to share them with all the other centers and translate them into different languagesshe indicated.

An emergency team

Sarah Thomas, registered nurse and manager of emergency management at BC Renal, said the network is unique because it works with the province’s five regional health authorities to plan for emergencies so dialysis patients can be discharged out of their home community if an evacuation order has been issued.

This could mean each health authority reviews its capacity to accommodate patients […] We offer this support to health authorities, who are busy caring for patients.

BC Renal recently created an emergency team of 12 hospital dialysis nurses who can be deployed to one of the province’s 29 community clinics or to another hospital offering the treatment, rather than transporting patients by plane – unless the area has been evacuated, Ms Thomas said.

Each nurse on the team teaches patients to start their renal emergency diet by limiting fluids and eating foods low in potassium, including berries, cauliflower and broccoli. Patients must also take a prescribed powder that can be mixed with water to lower blood potassium levels in the short term, until treatment is available.

BC Renal will also develop policy on how to accommodate dialysis patients when water restrictions are in place during a drought or if a water main breaks in a hospital. Each dialysis session uses up to 500 liters of water, three times per week per patient, in a procedure that also relies on electrical power.

Dialysis, a survival system

In the worst case scenario, we will probably have to move [les patients] to another region, explained Ms. Thomas. I know people think that [les unités de soins intensifs] are a survival system. But dialysis is also a survival systemshe argued.

We needed to find something to ensure we had agile emergency procedures, because if our patients don’t get the treatment, they will get sick, end up in the hospital and potentially die.

Health information for all kidney patients, whether they are on dialysis or have received a transplant, is stored in an electronic registry available across British Columbia, unlike other patient records, Thomas said.

This is unique to British Columbia. We created this. The rest of Canada is wondering: ‘What is BC Renal doing?’she said of the interest in the emergency preparedness program.

The nurse said the network’s enhanced emergency response plans began during the COVID-19 pandemic and a trio of climate change-related calamities that hit B.C. in 2021 – record wildfires , including one that nearly destroyed the town of Lytton, an unprecedented heat dome that led to 619 deaths in the province and an atmospheric river that caused flooding in the Abbotsford area.

We know that more climate emergencies will occur, and we will be better prepared to ensure patients receive the care they need.