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Emergency Preparedness in Continuous Kidney Replacement Therapy (CKRT)

In 2021, the United States experienced a pandemic, hurricanes, wildfires,  winter storms, water main breaks, and water contamination emergencies. ls your hospital prepared? Have you ever asked yourself?

  • How will my hospital treat acute and chronic patients requiring kidney replacement therapy (KRT) during an emergency? 
  • If water is not available or contaminated, how will we be able to provide kidney replacement therapy to our patients?
  • What if the acute patient census increases significantly and sufficient Continuous Kidney Replacement Therapy (CKRT) were machines not available to meet the need?

If you find yourself asking these questions, you are certainly not alone. Whether their condition is acute or chronic, patients with kidney failure need life-sustaining dialysis.

When an emergency threatens to disrupt treatments, it's critical for hospitals and other healthcare facilities to have plans and resources necessary to maintain this therapy at all times. 1 2

Complete the form to watch Melinda Keto* as she discusses:

  • Why emergency plans should be developed and the relevant Standards to use as guidance
  • Impact of emergencies and the ways hospitals may be affected
  • Machine and staffing considerations when developing emergency plans for KRT patients

About the Presenter:

Melinda Keto, Senior Healthcare Consultant, Healthcare Design Specialists LLC

Melinda Keto, RN*
Senior Healthcare Consultant for Healthcare Design Specialists LLC, Asheville, NC

Melinda has over 25 years of nursing experience in a broad range of specialties including adult critical care and pediatric emergency medicine, inpatient and outpatient hemodialysis, peritoneal dialysis (PD), and plasmapheresis. Currently, she serves as Senior Healthcare Consultant for Healthcare Design Specialists LLC. (HDS), an international consulting service company dedicated to the dialysis industry.

Prior to becoming a consultant, Melinda worked as a nurse leader in both pediatric and adult acute care facilities, spearheading initiatives such as EPIC Pediatric Nephrology Module development, telehealth programs for pediatric home PD, numerous dialysis and emergency department program modifications and developments, organizational COVID management, and FEMA Hospital Incident Command as Operations Section Chief. Melinda has served as a board member of the Renal Healthcare Association and has led numerous departments to zero deficiency regulatory surveys and remodeled programs, decreasing cost while improving patient safety and outcomes.

*Paid speaker for NxStage Medical, Inc.



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  1. Kohn, OF et al. Novel use of pre-mixed dialysate bags during water supply interruption in acute hospital. Kidney360. December 9, 2020.
  2. accessed 2/22/2022.

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