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Re-establishing clean water in a disaster.

When a disaster occurs, water systems can be overwhelmed with sediment, chemicals, microbes, and other harmful organisms. Dialysis clinics need to have disaster management plans and protocols in place to meet the demands of any situation. During emergency events, such as large widespread natural disasters, it is necessary to have the support of outside resources to keep the clinic operating or to aid in returning it to service as quickly and as safely as possible. Before proceeding with any medical treatments that use water, such as dialysis, facilities should address five different response actions to establish the safety and effectiveness of their water system. Test the water quality prior to treating patients. Make sure the system is working properly by performing critical water tests. Compare all results with pre-disaster data to help spot any warning signs. Inspect the water system, including all connections, timers, and settings. Consider contacting your water treatment vendor for additional verification and support. Be sure to closely monitor the water system equipment; make sure it is not overwhelmed by staying in touch with local water authorities. They may "shock" their distribution system to regain compliance. Make every effort to conserve water during this time. Change the water system. If the central water system has been compromised, consider using portable RO units or portable exchange DI tanks. Finally, moving your patients to another facility may be the only alternative, so work with other local facilities unaffected by the disaster.