How much water should we stockpile for emergencies?

Plan for 120L per dialysis station per session of packaged purified water. For a 10-chair center running 3 sessions/day, this is 3,600L/day. Arrange water tankers from approved suppliers with MOUs and specify that water must meet AAMI quality standards. Alternative: maintain MOU with neighboring dialysis center that has independent RO supply.

What if the generator fails during a session?

First, verify UPS is supporting critical systems. Then: (1) Assess generator status — is it the fuel, battery, or mechanical issue? (2) Transfer patients still able to tolerate to facilities arranged in MOU within 30 minutes drive, (3) For patients who cannot transfer (e.g., volume loaded, critical), maintain manual monitoring and resume when power restored, (4) Document the incident per NABH FMS.9 with root cause analysis.

How should pandemic patient triage work in dialysis?

Pre-entry screening: temperature check and respiratory symptom questionnaire for all patients before entering the treatment area. Suspect/confirmed patients dialyzed in designated isolation area (negative pressure if available, otherwise at end-of-row with closed door) with dedicated staff. Patients pending test results dialyzed last shift in isolation. Use extended dialysis hours to cohort COVID patients separately.

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PDF Protocol

Emergency Preparedness & Disaster Plan for Dialysis Centers

Comprehensive emergency preparedness plan for dialysis centers covering natural disasters, power failures, water supply interruptions, fire, pandemic response, and mass casualty incidents — aligned to NABH FMS and CDC emergency preparedness guidelines.

What's Inside

Risk Assessment

8 items

Facility-specific hazard vulnerability assessment covering seismic zone, flood risk, power grid reliability, and regional disaster history.

Power Failure Response

10 items

Generator capacity planning (minimum 48-hour fuel), UPS for critical systems, power-down protocol for machines, and emergency transfer arrangements.

Water Supply Interruption

8 items

Bottled/treated water reserves calculation (120L/session per station), RO system shutdown/safe restart protocol, and transfer to alternate facility criteria.

Fire & Evacuation

9 items

Fire zone classification, evacuation team roles, patient evacuation strategy (wheelchair, stretcher, bedridden), and rendezvous point assembly.

Pandemic Response

7 items

Patient triage for fever/respiratory symptoms, isolation station setup, PPE surge capacity calculation, staff cohorting, and telehealth contingency.

Communication & Recovery

8 items

Emergency contact tree, patient notification protocol (SMS broadcast), alternate facility agreements, and post-disaster continuity of care plan.

Preview

Emergency Response Standards (Sample)

Power failure: Generator must support 100% of dialysis center load for minimum 48 continuous hours with fuel reserves — includes dialysis machines, water treatment, lighting, HVAC for treatment areas, and communication systems (NFPA 99 / NABH FMS.8)
UPS: Critical electronic systems (patient records, machine data, communications) must have battery UPS providing minimum 30 minutes runtime for orderly shutdown — automated backup triggers within 2 seconds of mains failure
Water shortage contingency: Maintain minimum 2-day supply of packaged purified water (120L per dialysis station per session) — more if reliance on single municipal water source. Arrange MOU with neighboring dialysis center for emergency overflow
Fire evacuation: In-chair dialysis patients evacuated using wheelchairs or stretchers — do not disconnect patients during fire unless immediate life risk. Designated evacuation staff per treatment zone. Evacuation drill conducted once per 6 months with debrief documentation
Pandemic surge: Calculate 30% increased PPE burn rate (N95 masks, face shields, gowns) during pandemic surge. Minimum 30-day PPE stockpile per CDC recommendations for hemodialysis facilities
Patient communication: Emergency notification system with SMS broadcast capability reaching 100% of patient contact numbers within 15 minutes. Battery-backup phones and offline-capable communication tree posted in treatment area

Measurable Impact

Emergency checkpoints

48 hrs

Minimum generator fuel capacity

30 days

PPE surge stockpile

6 mo

Fire evacuation drill frequency

Based on Published Standards

NABH Standards for Hospitals, 5th Edition — FMS Chapter (Facility Management & Safety)

CDC — Emergency Preparedness for Outpatient Dialysis Facilities (2018)

Centers for Medicare & Medicaid Services (CMS) — Emergency Preparedness Rule (2016)

NFPA 99: Health Care Facilities Code (2021 Edition)

National Disaster Management Authority (NDMA) India — Hospital Safety Guidelines

Kidney Community Emergency Response (KCER) Coalition — Dialysis Facility Disaster Planning

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What's Inside

Risk Assessment

8 items

Facility-specific hazard vulnerability assessment covering seismic zone, flood risk, power grid reliability, and regional disaster history.

Power Failure Response

10 items

Generator capacity planning (minimum 48-hour fuel), UPS for critical systems, power-down protocol for machines, and emergency transfer arrangements.

Water Supply Interruption

8 items

Bottled/treated water reserves calculation (120L/session per station), RO system shutdown/safe restart protocol, and transfer to alternate facility criteria.

Fire & Evacuation

9 items

Fire zone classification, evacuation team roles, patient evacuation strategy (wheelchair, stretcher, bedridden), and rendezvous point assembly.

Pandemic Response

7 items

Patient triage for fever/respiratory symptoms, isolation station setup, PPE surge capacity calculation, staff cohorting, and telehealth contingency.

Communication & Recovery

8 items

Emergency contact tree, patient notification protocol (SMS broadcast), alternate facility agreements, and post-disaster continuity of care plan.

Preview

Emergency Response Standards (Sample)

Power failure: Generator must support 100% of dialysis center load for minimum 48 continuous hours with fuel reserves — includes dialysis machines, water treatment, lighting, HVAC for treatment areas, and communication systems (NFPA 99 / NABH FMS.8)
UPS: Critical electronic systems (patient records, machine data, communications) must have battery UPS providing minimum 30 minutes runtime for orderly shutdown — automated backup triggers within 2 seconds of mains failure
Water shortage contingency: Maintain minimum 2-day supply of packaged purified water (120L per dialysis station per session) — more if reliance on single municipal water source. Arrange MOU with neighboring dialysis center for emergency overflow
Fire evacuation: In-chair dialysis patients evacuated using wheelchairs or stretchers — do not disconnect patients during fire unless immediate life risk. Designated evacuation staff per treatment zone. Evacuation drill conducted once per 6 months with debrief documentation
Pandemic surge: Calculate 30% increased PPE burn rate (N95 masks, face shields, gowns) during pandemic surge. Minimum 30-day PPE stockpile per CDC recommendations for hemodialysis facilities
Patient communication: Emergency notification system with SMS broadcast capability reaching 100% of patient contact numbers within 15 minutes. Battery-backup phones and offline-capable communication tree posted in treatment area

Measurable Impact

Emergency checkpoints

48 hrs

Minimum generator fuel capacity

30 days

PPE surge stockpile

6 mo

Fire evacuation drill frequency

Based on Published Standards

NABH Standards for Hospitals, 5th Edition — FMS Chapter (Facility Management & Safety)

CDC — Emergency Preparedness for Outpatient Dialysis Facilities (2018)

Centers for Medicare & Medicaid Services (CMS) — Emergency Preparedness Rule (2016)

NFPA 99: Health Care Facilities Code (2021 Edition)

National Disaster Management Authority (NDMA) India — Hospital Safety Guidelines

Kidney Community Emergency Response (KCER) Coalition — Dialysis Facility Disaster Planning