Ice storm power outage, is it possible to wait it out and hook patient back up?

[greg10]

Some of you may have experienced winter storms in your location lately.  Well, we had one in the south east US overnight.  Of course the power stayed on until we were 30 minutes into a treatment, about 3 hours left.  Using our trusty APC 1500 UPS (uninterruptible power supply - battery back up), we figured enough power to do another 45 minutes to one hour) and hopefully the power would have been restored by that time.  Well, 40 minutes come and gone, the UPS is chirping away, the LED indicator on the UPS down to 2 out of 5 lights, then 1 LED.  Time to do a rinse back and we did uneventfully.

I left the cartridge in the cycler after rinse back, the cartridge is clean, some pink streaks in the lines as expected with very little blood left over, the lines are still uncontaminated.

45 minutes after that, the power was restored and seems stable as I am typing on the PC.

My question to any NxStage users out there who may venture a guess.  Is it safe or even possible to hook up to the same used cartridge and cycler again, given appropriate dose of heparin again of course, and start or continue the dialysis again?

I think I am going to get a bigger UPS next time or may be three in series.  This APC 1500 is good, but you can't expect it to last 3 hours.  BTW, the first thing I did after outage was to turn down the heater in the Pureflow, from about 14 to 5, just so that the battery power would last longer.

Thanks.

[jbeany]

Personally, I wouldn't risk it.  They should have given you enough extra cartridges to hook up a new one and finish the full run without cutting into your supply.  You really can't see the very inside of the filter, so who knows how much blood is really left in there.  Why take a chance on returning a blood clot?

[greg10]

Personally, I wouldn't risk it.  They should have given you enough extra cartridges to hook up a new one and finish the full run without cutting into your supply.  You really can't see the very inside of the filter, so who knows how much blood is really left in there.  Why take a chance on returning a blood clot?

Thank you for your insight and I think you are probably right.  Unfortunately NxStage has been quite stingy with their cartridges.  We received 3 boxes (18 cartridges total) from the last shipment for this month.  Normally if you do 5 treatments a week, there should be about 22 treatments per month.  We will be out of cartridges by the day of the next expected delivery and I have informed NxStage of our inventory.

[The Lone IT from HM]

Here is a solution that isn't in everyone's financial abilities to reach. http://www.harborfreight.com/engines-generators/gas-engine-generators/800-rated-watts-900-max-watts-portable-generator-66619.html

This is a little 800 watt Generator for $129 (at the moment).  You don't need it often...but, when you do, this is not that much to spend for insurance.  It is one of those things you need to remember to service and run at least once a month, so you know it will work when you need it, and you know how to start it when the time comes.

[greg10]

..
This is a little 800 watt Generator for $129 (at the moment).  You don't need it often...but, when you do, this is not that much to spend for insurance.  ...

Thank you and I do have a portable generator, but I did not want to leave the patient alone for too long a period of time in order for me, as the caretaker, to dig it out of the garage and set it up properly.  The UPS (battery backup) actually cost more than a small generator, but of course the advantage is that it switches the cycler over to battery power without a blink, the disadvantage is that the model APC 1500 I have will only do about 45 to 60 minutes of backup power for the NsStage.  There are large generator setups that has automatic transfer switches that can do the same thing, but it costs quite a bit more and lots of wiring installation is required, the UPS is just a simple plug in operation.

[jbeany]

Somewhere on here is a discussion of slowly, gradually, ummmm...."fudging" the self-reported inventory.  Just a little extra here, a little extra there, and poof, you have an extra box for power emergencies.  I don't think you need an extra couple of months supply, but an extra box or two goes a long way to making you feel more secure about delivery mix-ups and other odd circumstances.

[The Lone IT from HM]

so true on all counts!  I guess one needs to have the generator ready all the time for situations of unexpected power outages.  I have two Generators, and I never give it a thought to have one in place when a bad storm in expected.  Of course, our power goes out for no other reason than the transformer across the street blows a fuse and scares the hell out of us. it goes with a really BIG BOOM.  That takes as long as 90 minutes for them to come out and fix.   And I still don't bring up my Generator.

The nice thing about an UPS is that you can unplug it from the wall and into an extension cord, if you are in a poweroutage that is running long.  UPS's are not fussy about what they are plugged into and will continue to supply power while you move the plug to a different power source.

[lmunchkin]

We have had quite a few outages here where we live and the unique thing with NxStage is that you can do a manual rinseback and dialysize him/her the very next day! You are not risking a clot or God knows what to your loved one! That is what sooooo special about NxStage.  When the pump on machine is not running for any lenght of time, you really must be careful in continuing with tx. I personally wont risk it!  I just start all over the next day!

lmunchkin

[del]

We use a regular dialysis machine instead of nxstage (it's not availabe in Canada) and we are told to order extra supplies all the time just in case of power outage or late deliveries.  We always have at least 2 weeks (more during the winter) of extra supplies on hand all the time.

[willowtreewren]

Greg,
I added a column to the inventory sheet that I e-mailed to NxStage. After what I had on hand on the date of the inventory, I calculated haw much I wanted them to send and put that in the last column. They were good about filling my order the way I wanted it filled. I only got flak over extra bags for those times that we came home and the SAK had had a problem.

(Where are you....I have 6 cases of cartridges that we are going to have to dispose of).

Aleta

[greg10]

Hi Aleta,
  Thank you so much for your earlier PM and your posts.  I tried to PM when I first received it, but your PM was full.  So I have just now sent you an email.

  I never had much luck getting NxStage to give me a sufficient inventory of cartridges that I feel comfortable.  For example even though I requested an additional week (5 cartridges) of spare inventory last month, they left me with only 2 spare cartridges.

  Thank you for your kind offer and I have replied in the email.