Kidney, Heart and Lung Patients: A Flood-Season Readiness Plan

The plan in one line: if someone at home depends on dialysis, oxygen, an inhaler or heart medicines, pack their go-bag before the rain gets heavy, know a second clinic, and leave early. Waiting until the water is at the door is when missed dialysis and empty cylinders turn dangerous.

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Floods shut roads, cut power and close clinics, sometimes for weeks. A healthy person can wait that out, but a person on dialysis three times a week, or living on home oxygen, or managing heart failure with a careful balance of medicines and fluid, can’t, and the families who come through best are nearly always the ones who decided what to do before the river rose. Here’s that decision, written down.

What goes in a flood go-bag for a chronic patient?

One bag per patient. Keep it by the door from the first monsoon warning onwards, with every paper item sealed inside a zip bag or wrapped in two plastic bags, because a folder of reports that survives the water is worth more to a stranger doctor in a camp than any amount of explaining from a worried relative.

1. Medicines for at least 7 days, in their original strips or bottles, plus inhalers and a spacer.
2. A written medicine list: each medicine’s name, strength and timing, copied from the prescription, with allergies at the top.
3. Prescriptions and recent reports: latest creatinine and potassium for kidney patients, ECG and echo summary for heart patients, discharge letters.
4. Phone numbers on paper: the treating doctor, the dialysis unit, the oxygen supplier and two relatives. Phones die.
5. A charged power bank and a torch.
6. ID card and any health or welfare card.
7. Safe water (a 1.5 litre bottle) and a few dry snacks suited to their diet.
8. Mobility aid if they use one. Our guide to choosing a walking stick, walker or wheelchair helps if theirs is lost.

Photograph the list and reports on two phones too. Paper gets wet.

Kidney patients on dialysis

Missing dialysis is the biggest danger, because without it potassium and fluid keep building up in the blood between sessions, and a high potassium level can make the heart beat in a dangerous rhythm, often with no warning signs at all until it is already an emergency. Don’t gamble on it.

• Ask the dialysis unit now: “If you close, where do I go?” Get the name and number of a backup unit.
• Ask the kidney doctor or dietitian for an emergency diet plan for days when dialysis is delayed. It usually means stricter limits on fluid, salt and high-potassium foods. The kidney team sets these limits for each patient.
• Keep a copy of the dialysis schedule, access type (fistula or catheter) and dry weight in the go-bag.
• Keep a fistula arm or catheter site dry and clean, and out of floodwater.

Go to hospital at once for breathlessness, chest pain, a weak or irregular pulse, swelling that’s spreading, confusion, or muscle weakness.

Lung patients: oxygen and inhalers

A concentrator stops when the power stops. A cylinder runs out. Plan for both.

• Ask the supplier how many hours a full cylinder lasts at the prescribed flow, and keep at least one full backup.
• Keep cylinders upright, tied or wedged so they can’t fall, and far from stoves, candles and smoking. Oxygen makes fires burn fiercely.
• Carry reliever and preventer inhalers plus the spacer. Damp and mould in flooded homes can make asthma and COPD worse.
• A pulse oximeter is useful if the doctor has told you the patient’s usual reading and the level that means hospital. Our article on checking oxygen level at home explains how to take a reliable reading; adults follow their own doctor’s target.

Blue lips? Go. The same goes for being unable to finish a sentence, confusion, drowsiness, or a reliever inhaler that isn’t helping.

Heart patients

• Carry all heart medicines, including blood thinners, and list them clearly. Doctors treating an injury must know about blood thinners before stitching or surgery.
• For heart failure, weigh daily if a scale is available. A gain of about 2 kg in 2 to 3 days, or more swelling of the feet, means fluid is building; call the doctor.
• Heat and stress strain the heart. Rest in shade and drink as much as the doctor allows; some heart and kidney patients have a fluid limit.

Chest pain lasting more than a few minutes, sudden breathlessness, fainting, or a pulse that is racing or very slow needs emergency help now, even if the roads are bad and the hospital is far, because heart emergencies get harder to manage with every hour that passes and the rescue services would rather come early than late.

When to evacuate early

Go sooner than everyone else.

1. When a flood or heavy-rain warning is issued for your area, move the patient to a relative or shelter on higher ground near a working hospital.
2. If dialysis is due in the next 2 days and roads may close, go now and stay close to the unit.
3. If the oxygen supply is down to one cylinder, move before it runs out.
4. If the patient is bed-bound, arrange transport and at least two helpers in advance.
5. Tell the local rescue or union council office that a dependent patient lives at your address.

You’ll find more flood-season guides in the Barsaat and Flood Season hub.

Chronic illness and floods: questions families ask