Tropical Storm Fay

As of 9:00 a.m. (Eastern Time) Thursday morning, the center of Tropical Storm Fay was located in the east central Florida coastal waters, approximately 20 miles east of Daytona Beach. Maximum sustained winds remain near 60 mph. Fay has been nearly stationary during the past few hours but is expected to begin a slow west-northwest motion towards the east central and northeast Florida coast line during the morning hours. Sustained tropical storm force winds will spread along coastal areas of northeast and east central Florida through Thursday morning.

Rain bands along the south side of Fay’s circulation will continue to produce flooding over the saturated soils of east central Florida. Locations south of Brevard County could experience storm totals near 30 inches of rain. Flood watches remain in effect for central and northeast Florida. A flash flood warning is in effect for Brevard County until 12:00 pm Thursday. A flashflood warning means that flooding is imminent or occurring. Take immediate actions to protect life and property.

Travel is not recommended anywhere in east central Florida tonight. A tropical storm warning is in effect for Fort Pierce northward to Altamaha Sound, Georgia. A tropical storm warning means that tropical storm conditions are expected within the next 24 hours. An inland tropical storm warning is in effect for interior section of east central and northeast Florida. This means that tropical storm conditions are expected within the next 24 hours.

Even if you are not in the path of the storm, it is a good opportunity to review and practice your disaster plans. This includes educating your patients and helping them to develop their disaster plan. Patients should be informed where to go, what to do and who to contact. The following are key areas to address in preparing patients:

• The Network has made available patient ID cards. Encourage your patients to use them. Additional copies can be downloaded from the FMQAI website at http://www.fmqai.com/ESRD/pdf/Emergency%20Hurricane%20Cards.pdf
• If an evacuation order is issued, patients should be given a copy of their treatment orders, medications, instructions on their emergency diet, a list of Florida dialysis facilities and facility emergency contact information. (Please do not distribute the phone numbers marked for “Staff Use Only” to patients.)
• If the patient is evacuating, ask where they plan to go and for an out of area contact number.
• Peritoneal dialysis patients and home hemodialysis patients should be contacted and prepared with ample supplies and information on how to contact their supplier.
  

Due to the current weather situation, please remain aware of updated advisories. The following are useful links that may benefit you as well as your patients:

Link to local EOC
http://www.floridadisaster.org/County_EM/county_list.htm

Link to Emergency Guide for People on Dialysis
http://www.medicare.gov/Publications/Pubs/pdf/10150.pdf

Link to Emergency Preparedness Guide for Dialysis Facilities
http://www.fmqai.com/ESRD/pdf/CMSDisasterPlanningGuide.pdf

Following the storm, please contact the Network to advise of your facility’s status and if you are in need of assistance. Also, please notify the Network if you are unable to locate one of your patients, as well as if you are assisting another facility by dialyzing one of their patients. Thank you for your ongoing attention to the safety of your patients.

Network Office – 813-383-1530

CMS Draft Interpretive Guidelines Published

The Centers for Medicare & Medicaid Services (CMS) has posted the “draft” interpretive guidance that will guide the survey process for the new ESRD Conditions for Coverage.

The document includes the regulatory language that was published as a final rule for the ESRD program in the Federal Register on April 15, 2008, as well as regulatory text that was incorporated by reference in that final rule.

Comments and rationale pertaining to the “draft” Interpretive Guidelines can be submitted to the CMS mailbox at ESRDSurvey@cms.hhs.gov no later than 5:00 p.m. Eastern time on August 18, 2008. A template to submit comments and rationale is included in the guideline document.

You can locate the “draft” Interpretive Guideline document on the FMQAI website at http://www.fmqai.com/ESRD/.

Coping with disasters

Disasters can have a far-reaching impact on victims and responders. But you don’t have to be a disaster victim to experience the anxiety and stress. Disasters can cause widespread physical damage, but they can also cause emotional damage.

A disaster can make you sad, angry, confused, or scared. These emotions are very common. But sometimes, these emotions can last a long time or keep you from doing daily activities. You should be able to recognize the warning signs that you or your loved ones are experiencing difficulty.

Sometimes anniversaries of disasters can trigger anxiety. There are many organizations that can help you cope with disasters. If you are a dialysis or transplant patient, talk to your social worker about your feelings.

There are many resources on the Internet where you can find help. Here are just a few:

• http://mentalhealth.samhsa.gov/disasterrelief/psa.aspx
• http://emergency.cdc.gov/mentalhealth/
• http://www.redcross.org

Lightning Safety Week!

When Thunder Roars, Go Indoors!
Lightning Safety Week: June 22-28, 2008

Florida is the Lightning Capitol of the U.S., leading the nation in lightning deaths. Lightning kills an average of nine Floridians each year, more than any other weather hazard, and injures an additional 37 people.

Most people who are struck by lightning are not killed, but they are left badly bruised and burned. The force of being hit by lightning can literally blow off people's shoes, shred their clothes and throw them violently through the air. It not only hits you hard, but at 50,000 degrees, it also burns right through you, leaving you with disfiguring scars and internal damage.
Lightning survivors often have pain, loss of memory and other bad effects that sometimes last a lifetime.

A darkening cloud is often the first sign that lightning may strike. As soon as you see lightning or hear thunder, you are immediately at risk. By playing another inning or waiting even a few minutes to see if the storm is getting closer, you could be risking your life.

Go immediately inside a house or other enclosed structure to stay safe. No place outdoors is safe! Covered vehicles are fairly safe locations, but remember to keep your hands and feet away from the side of the car and away from the dashboard, steering wheel and windows.

People that have been struck by lightning do not carry an electrical charge. If you and the victim are in a safe area, it is safe and recommended to perform life saving first aid. You will not “get shocked” by touching the victim.

How far away is lightning from you? Use the FLASH to BANG method:

• When you see the FLASH
• Count the number of seconds to the BANG of thunder,
• Divide this number by 5,
• And this gives you the MILES the lighting is away from you.

It is recommended that if the thunder arrives within 30 seconds or less from your location, you should seek shelter. Wait thirty minutes after the last thunder before going outside.

http://www.lightningsafety.noaa.gov/

"All Hazards" now an online continuing education course

FMQAI: The Florida ESRD Network (Network 7) is pleased to present All Hazards I: Identifying and Preparing for Potential Emergencies and Disasters.

This free online continuing education course will provide 1.0 continuing education contact hour for Florida nurses, social workers, and dietitians.

This is an exciting opportunity for dialysis providers to fulfill the CMS Conditions for Coverage which outline staff training on disasters.

For more information on the course, visit http://edu.flqio.org/ and click on "ESRD Courses."