March 16, 2017 - Two weeks ago, we had the opportunity to host a roundtable discussion on preparedness for managing cardiovascular disease and end-stage renal disease during and after a disaster. The first event in our Diseases and Disasters series of discussions, this session focused on the unique needs patients with these chronic diseases can encounter during an event impacting their care. Representatives from patient advocacy organizations, federal agencies, non-profits and other public health preparedness policy experts gathered around the same table to talk about challenges and solutions patients face, and even make new relationships. In advance of the release of the proceedings from the meeting, we’re pleased to share major highlights below.
The roundtable discussion began with a conversation about the needs and vulnerabilities that are presented during a disaster. Key takeaways centered around continuity of critical care. Dialogue on patient access to essential equipment and transport to healthcare facilities dominated this part of the session. For patients on dialysis, the most crucial aspect of the conversation concentrated on finding a source of power and ensuring access to clean water. Other priority medical supplies were mentioned, such as access to clean bandages, hand wash, and antiseptics. Attendees mentioned these supplies are often overlooked during disasters by caregivers and providers because their focus is usually on the patient. Attendees stated it was crucial to be able to move quickly in these situations in order to ensure patients receive proper care, but also noted that too often the patient is responsible for coordinating their own transportation. Representatives from the kidney community also encouraged kidney patients and their caregivers to contact their local power company to be placed on a priority restoration list.
Attendees also discussed the needs of patients with cardiovascular disease during a disaster. Many of these patients rely on chronic medications and an interruption of these medications in any situation can prove fatal in any serious cardiovascular event. Many of these patients also rely on chronic oxygen therapy as well, underscoring the critical need to ensure displaced persons have access to cardiovascular disease medicines and medical products. It is imperative that response protocols and healthcare and relief systems set up in a way that they can readily provide access to these medications. Certain bioterrorism agents and diseases can also increase the risk of cardiovascular conditions. Conditions such as mild stress, air pollution and other factors can actually lead to an uptick in myocardial infarctions during a disaster. Essentially then, the environment of a disaster and compound the cardiovascular disease and the impacts of interrupted medication. There were also concerns raised about the availability of cardiovascular emergency services in crowded medical emergency rooms dealing with trauma and infectious disease. Many disasters may lead to an increased surge in care for trauma or infectious disease patients depending on the type of disaster. There needs to be a specific system that caters mainly to the needs of cardiovascular disease patients in these situations.
Another big issue discussed was the education of patients and how to inform and empower them in order to help them become more self-sufficient in case of emergencies. One solution to this was having patients carry a card with the prescription and dosage of medication needed by each patient, such as our Rx on the Run resource. This card could also potentially become available on a smart phone and be able accessible to patients and providers in emergency situations.
This round table discussion brought up crucial issues and viable solutions to better manage patients with cardiovascular disease and end stage renal disease. Overall, the feedback we received allowed us to get a better idea of what actionable items there are and what immediate actions can be taken for preparation and for the patient. Also, looking at what our community – planners, coordinators and policymakers – can do as a collective. This round table is the first in a series of discussions on topics that intersect with disaster preparedness and response that will take place over the next few months. It is our hope that this is the beginning of more open conversations that will help to further engage the healthcare community and work towards collaborative solutions and partnerships to address these challenges.
****The next Diseases and Disasters round table discussion is a virtual round table on Friday, March 31 at 1:30pm ET. We'll be discussing challenges with managing diabetes and continuing conversation in managing end stage renal disease and other kidney patient concerns. Email us with any questions at firstname.lastname@example.org.