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Oct 14, 2024

Power outages can be risky for those relying on medical devices : Shots - Health News : NPR

By Ginny Graves Jenny McClelland’s 13-year-old son, James, was born with a rare genetic condition that makes him unable to breathe when he’s asleep. To stay alive, he relies on a ventilator with an

By

Ginny Graves

Jenny McClelland’s 13-year-old son, James, was born with a rare genetic condition that makes him unable to breathe when he’s asleep. To stay alive, he relies on a ventilator with an attached humidifier, which makes the air less painful to breathe, a pulse oximeter to track his oxygen saturation and a suction machine to remove secretions that collect in his airway. Every device requires electricity.

When the power goes out in their Clovis, Calif., home, as it does at least a couple of times a year — sometimes for days at a time — the clock starts ticking.

“For years, we relied on the battery in his ventilator, which lasts about four hours,” McClelland says. “We learned how to jerry-rig the circuit to bypass the humidifier, so it would use less battery and buy us a little more time to figure out what to do next.”

As power outages caused by grid failures or extreme weather become more common — Hurricane Beryl leaving millions without electricity in Texas is the most recent example — people who rely on home medical devices face a growing risk. Some 4.5 million Medicare recipients and likely millions more of those with private insurance use such electricity-dependent equipment, including electric wheelchairs, hospital beds, ventilators and oxygen concentrators.

These can be game changers for people with a variety of conditions, allowing them to stay in their homes and function independently but leave them reliant on stable electricity.

And climate change is fueling “more frequent and more severe weather events” and power outages, says Joan Casey, associate professor at the University of Washington’s Environmental and Occupational Health Sciences Department.

Some 80% of all the major outages from 2000 to 2023 were due to weather, according to a recent analysis by Climate Central, a nonprofit research group. High winds and rain, winter storms, and tropical cyclones, including hurricanes, were the most common causes, but wildfires and floods contributed, too.

What’s more, when Casey and her colleagues studied outages across the U.S. between 2018 and 2020, they discovered that weather-related blackouts are more likely than electrical grid failure outages to last eight hours or more — the length of time that’s considered “medically relevant,” since that’s when batteries on most medical devices become depleted.

Longer outages were also more likely to affect poorer counties, which tend to have a high prevalence of durable medical equipment users, many of whom don’t have a backup power source, like a generator or battery power bank. “That equipment costs thousands of dollars, and people who live in apartments can’t use generators because they’re not safe to use indoors,” says Casey.

While having a source of backup power is helpful, it’s not a replacement for a well-thought-out disaster plan, says Sue Anne Bell, associate professor at the University of Michigan School of Nursing, who studies the health effects of disasters. Here’s how to plan ahead:

Backup power: Familiarize yourself with the battery life of your specific equipment, jotting down the model and serial number of your medical devices. Keep all equipment instruction manuals in one easy-to-find place, and make sure to keep backup batteries charged, especially if the weather report is ominous. If possible, purchase a device called an inverter, which lets you charge batteries through your car’s cigarette lighter or 12-volt port.

Communications: Call your local fire and police stations to let first responders know that you rely on home medical equipment. Many keep a list of people in the area who are particularly vulnerable. Identify the locations of emergency shelters and power stations, and make a list of important numbers — your doctor, home health agency, medical equipment company or oxygen provider, as well as friends and family who are willing to step in and help — and post it near your phone (ideally a landline, in case your cellphone dies).

Also vital: Tell your local utility company that you rely on home medical equipment; many will prioritize restoring your power. During an outage, keep tabs on the utility company’s estimate of when your power will be restored. It’s a good idea to have a hand-crank battery-powered radio on hand to stay on top of the latest news.

If you use a ventilator, oxygen concentrator or a left ventricular assist device, or LVAD: For all of these, “you should create a step-wise plan,” says Bell. “What’s my second source of power? What’s my third? Who can I call for help if those fail?”

Contact your local utility company to see if they have a program that provides a battery power bank to people who use home medical equipment. In some cases, insurance may pay for generators, too, according to Dr. Nate Goldstein, president of the American Academy of Hospice and Palliative Medicine.

McClelland was able to get a portable battery power bank for her son James’ ventilator for free through Pacific Gas & Electric’s Disability Disaster Access and Resources program. “The battery unit gives us power for at least two days. When the life of your child depends on medical equipment, you get used to life-threatening events. But it makes you realize how fragile the system is,” she says.

If someone in your home uses a ventilator, keep a resuscitation bag on hand, and teach yourself how to use it. For those with oxygen concentrators, suppliers should also provide stand-alone oxygen tanks, which don’t rely on electricity, says Dr. Albert Rizzo, chief medical officer of the American Lung Association. If yours doesn’t, ask for them. Regular oxygen tanks can last for 24 to 48 hours, he says, depending on how many liters you need per minute. Calculate the number of tanks you should have on hand based on your flow — and ask your health care provider if you can safely use a reduced rate to extend your supply. Don’t use candles or gas lights when you’re using oxygen.

If you are bed-ridden: Many people on hospice or those recovering from a serious injury or illness at home have a plug-in hospital bed, which can be raised and lowered, and an alternating pressure air mattress, to reduce the risk of pressure sores. “The beds usually have a manual override so they can be moved by hand,” says Goldstein. The mattress, on the other hand, deflates when the power goes out, so you need to replace it with something simple, like a foam mattress. “To avoid pressure sores, caregivers should turn patients on a regular schedule and familiarize themselves with techniques for using pillows to position them to reduce the risk,” Goldstein says.

If you sleep with a CPAP or BiPAP: “Most people are OK without it for a night or two,” says Rizzo. But it makes sense to have a charged backup battery pack and an inverter. If your device has a humidifier, make sure you have plenty of distilled water on hand, as well.

If you take insulin or other drugs that need to be kept cold: When it’s stored in a refrigerator at 36 to 46 degrees, insulin maintains its full potency — and your refrigerator will stay cool for two to three hours if you keep the door closed. After that, the drug is probably OK at room temperature — so long as it’s below 86 degrees, when insulin begins to break down, losing potency. If the liquid changes color or has clumps or crystals in it, don’t use it. You can put it in a cooler, but if it freezes, discard it.

“The key when you’re using unrefrigerated insulin is to monitor blood glucose levels. If they begin to rise to a dangerous level, or you develop excessive thirst or urination, nausea or vomiting, seek medical attention,” says Dr. Robert Gabbay, chief scientific and medical officer at the American Diabetes Association.

A number of other drugs require refrigeration as well, so it makes sense to read the label carefully or check with your doctor to see which ones might go bad in an outage.

Ginny Graves is a freelance journalist in the San Francisco Bay Area focused on science, health and psychology.