As Hurricane Lane approaches, health officials on high alert are making emergency preparations for the state’s most vulnerable patients.

“It’s going to come close to Oahu, closer than we would like, meaning there’s a chance we can get hurricane-strength wind and rain … and that’s concerning,” said Chris Crabtree, director of the Hawaii Healthcare Emergency Management Coalition, which comprises 170 medical facilities statewide that leverage medical personnel, equipment and supplies, and coordinates services during major emergencies or disasters. “It puts a lot of the infrastructure we have at risk. We’re turning up all our gears now based on the current forecast — kind of the whole nine yards. Basically, our battle rhythm is we’re all tightly linked, coordination-wise.”

Doctors are putting dialysis patients, who typically need treatment at least three times per week, on water and potassium-restricted diets and are making contingencies to move them between islands for services if necessary, said Dr. James Ireland, medical director at Fresenius Dialysis.

“For the dialysis machine to function, you need power, basically electricity, and clean water, so the fear is when there’s a big storm or hurricane … you lose power and you lose water for a period of time,” he said.

There are approximately 3,000 to 4,000 dialysis patients in the islands.

“If your potassium goes too high, that could be fatal. (We’re asking them) to restrict their fluid intake so their lungs don’t fill up with water if they miss a dialysis session. Most people can miss one session and not be adversely impacted, but if you miss two, three or four treatments, that can be fatal.”

Power struggle

Other patients who depend on electricity to survive, including those using home ventilators, are also a concern, he said.

“If they lose their power, they could die quickly,” Ireland said. “There’s lots of different vulnerable groups.”

Home health and hospice agencies are working with the families to come up with plans in the event of an emergency power outage, Crabtree said. Community shelters can also notify the coalition, which would help find beds for high-acuity patients, he said, adding that patients dependent on electricity should have backup generators at home.

Crabtree said he is updating facilities with the latest information from state emergency management briefings so that health providers can determine whether to postpone outpatient services, increase emergency personnel or activate their command centers, the central points of communication and planning that help maintain operations.

He said that he is waiting until the last forecast today to activate a 110-person disaster medical response and recovery team that includes doctors, nurses, paramedics and administrative and logistical support.

Another 20-person team is on standby.

‘Constant state of readiness’

The Queen’s Medical Center said it is “in a constant state of readiness.”

Contingency plans are in place, and an emergency preparedness team is scheduled to meet today to discuss details of the hospital’s food and medical supplies, as well as postponing elective procedures. Hawaii Pacific Health’s Emergency Management team also is assessing resources and supplies at each of its hospitals.

“Facilities do internal inventory so they know exactly how much food and how much supplies they have,” Crabtree said. “They’re topping off fuel (in their generators). Hospitals can last at least a week. A lot of them can last longer if they ration. They have more than what they generally need in preparation should something happen if the ports are out.”

The Hawaii Healthcare Emergency Management Coalition also has stockpiles of emergency medical supplies housed in a Halawa warehouse and a tunnel in West Oahu, he said.

Kaiser Permanente spokeswoman Laura Lott added, “I’m sure you’ll find most hospitals are testing generators, checking supplies such as food, bottled water and medications as well as communicating with staff about the importance of having a home hurricane preparedness kit.”

Not all health care facilities will be able to continue operating during the storm.

The Island Urgent Care clinics would close in the event of a natural disaster, said founder Dr. Robert Ruggieri.

“We don’t have funding and personnel and equipment to stay open,” he said.

U.S. Sen. Brian Schatz (D-Hawaii) announced Tuesday that federal agencies, including the U.S. Department of Health and Human Services, are standing by to provide support for public health and medical assistance as the storm makes landfall.

“As the situation becomes more serious, the federal government will continue to prepare, and residents should, too,” he said.