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The one-page emergency plan every dialysis patient should have — chest pain, breathing trouble, access emergencies, missed sessions, and the numbers to call.
Evidence reviewed & updated: 2026-08 — reflects the latest published trials and guidelines.
Emergencies on dialysis follow predictable patterns — access bleeding or infection, chest pain, breathing trouble, and severe fluid overload — and each has a correct response. A one-page plan (symptoms → action → numbers) taped to the fridge converts panic into procedure. Build it once, review it with your team, and share it with your household.
Chest pain, severe breathlessness, or fainting — on or off dialysis — are 911 events: call, say 'dialysis patient,' and follow dispatcher instructions. Fluid overload (breathlessness with rapid weight gain) is the classic dialysis emergency between sessions — it needs urgent ultrafiltration, not waiting.
Access bleeding: apply firm, direct pressure with your hand or a clean cloth for at least 10-15 minutes — not a wringing pinch — and get to care. An infected access with fever is the other access emergency: same-day treatment, because infection spreads to the blood fast.
Missed sessions are a medical event, not a scheduling one: the fluid and potassium load accumulate, and the temptation to 'fix' it by running harder next session is dangerous. Call the center the same day, let them plan (sometimes extra time or a temporary adjustment, sometimes an urgent check), and never self-adjust.
A pattern of missed sessions needs a conversation — with the team, not a scolding: transportation, symptoms, and mental health all cause skips, and all are solvable.
The one-pager: (1) emergencies list with the exact action (call 911 vs call center), (2) numbers — 911, center, on-call nephrologist, family member, (3) your medication list and diagnoses, (4) your dialysis schedule and access type, (5) a box for 'when to call the center': weight gain >2-3 kg, fever, access redness, low blood pressure symptoms.
Review it with your care team every few months, keep a copy on the fridge and in your wallet, and run through it once with your household — the people who will actually use it.
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