By Linda Gromko, MD and Jane C. McClure

Some people won’t consider home dialysis because they worry they won’t be able to handle an emergency that might arise. We appreciate these concerns, but know that thinking and planning ahead can help you dialyze at home with greater comfort and safety than in a professional center.

Remember that at home, your “patient” is the only patient. Infection risk is greatly reduced because of that factor alone. Nobody cares more about the quality and safety of your dialysis than you do! Besides, if the professionals at the center are dealing with another situation, they cannot give you the one-on-one consideration that you and your partner require.

Will you experience alarms from the dialysis machine at home? Of course you will. But you will be trained in how to respond to these alarms. Plus, you have two hotlines available to you at all times: the on-call nurses at your dialysis center – and the technical support team from the dialysis machine company.  They are helpful and responsive.

Is it possible that you will experience a true emergency while performing a treatment at home?  It is possible, though probably not likely. And, you have help available to you in the form of the above hotlines as well as your local emergency personnel.

Here are some ideas that will help keep you safe, whether you’re just getting started or fine-tuning your home set-up:

  1. Place a label with your two hotline phone numbers, i.e., the dialysis nurses at your center, and the technical support team from your dialysis machine company, right on the front of your machine!  You can program these numbers into your phone, too.
  2. Always have a fully charged phone available in case you need to call a hotline or 911. You may never have to call, but if you do, we promise you won’t want to be hunting for a phone. Know exactly where that phone is; keep it in the same place as you start each treatment.
  3. Have a rechargeable flashlight ready to go before starting any treatment that may take you beyond daylight hours. You can keep a rechargeable flashlight plugged into an electrical outlet near your machine; just make sure you use the same outlet every time.
  4. If you live in an area with frequent power outages, you may want to consider having a backup power generator. During your training, you will learn how to end a dialysis treatment quickly, i.e., by performing a Manual Rinseback.
  5. Have your instruction manual at the ready – always sitting in the same place for every treatment – in case you come across a machine alarm signal you aren’t familiar with.
  6. Keep your sheet of special instructions in a consistent place every time. That way, you will know exactly how to perform a Manual Rinseback quickly.
  7. Keep your “Clamp and Cut Kit” on the shelf under your machine as well. The Clamp and Cut Kit is the pack with supplies needed to get the dialysis patient off the machine and away from the house in a dire physical emergency such as a house fire or an earthquake! May you never, ever have to use this! But, knowing exactly where it is will give you peace of mind.
  8. If your “patient” has special medication needs, keep those medicines in a consistent place, immediately at hand. Examples would include inhalers for asthmatics or nitroglycerine tablets for folks with angina. Again, if the need arises, you want to be responding – not hunting for medications.
  9. Take a good look around your home dialysis center. Is it cluttered to the point that you – or emergency helpers – cannot maneuver easily? Are waste lines presenting trip-and-fall risks to the Care Partner or visitors?

Does all this sound daunting? Notice the consistency we stress: having emergency equipment like manuals, phones, and flashlights kept in the same place for each and every treatment! None of this is difficult to do, but it’s smart to think of these things in advance and build them into your systems from the very beginning.

Linda Gromko MD is a Seattle Family Physician who assisted her late husband with both home hemodialysis and peritoneal dialysis. She and Seattle Interior Designer Jane C. McClure co-authored the book, “Arranging Your Life When Dialysis Comes Home: ‘The Underwear Factor.’”

Join them in a four-part series on Setting up Your Home Dialysis Unit. Later blogs will include: Part 2: Setting Up with Safety First, Part 3: Designing Your Dialysis Unit, and Part 4: Storage and Organization Solutions for Home Dialysis.