The thought of a power failure is frightening for people who rely on electrical equipment to breathe, but with some preparation, the impact of power outages can be minimized. After consultation with your respiratory care team and the manufacturer of your equipment if necessary, a plan of action should be written down and all carers fully trained.

We have provided an Action Plan template at the end of this document which you can adapt to your personal circumstances.

The main things you can do to prepare for a power failure are:
• ensure charged back-up batteries are always available for ventilators
• have a plan in place for power outages that may last longer than your battery life
• ensure that carers will be alerted in the event of a power failure
• ensure you have a ‘bag valve mask’ available at all times
• register your home as ‘dependent on life support’ with your electricity supply company
• always have a torch, phone and important phone numbers handy
• make a plan for other essential electrical equipment
• have an evacuation plan
• practice the plan of action with each carer

Further information

Back up batteries
Ventilators that have an internal battery will automatically switch to battery power when the mains power goes off. The internal battery will provide approximately two hours of operation. It is charged whenever the ventilator is plugged into mains power.

VPAP and BiPAP machines often do not have an internal battery. They can be connected to a 12 volt external battery via a DC to AC inverter but cannot be connected to mains power and the external battery at the same time. Therefore, the battery must be charged separately and connected to the ventilator when the power fails.

An external battery, when connected to the ventilator will provide between 6 and 24 hours of operation, depending upon the type of ventilator, its settings and the size of the battery.

Batteries should be kept well maintained and fully charged. Carers should know how long each battery will last, how to check the amount of power left and how to change over to spare batteries. It is a good idea to use the external battery periodically then re-charge it to ensure that it is ready to use if/when there is a power failure.

Your humidifier should not be used when operating the ventilator from the external battery. It uses a lot of power and will significantly reduce the operating time of the battery.

If you are highly dependent on your ventilator it is recommend that you have a second ventilator available (with its own battery) in case any part of the machine should fail. In Victoria a second unit is supplied to all people who use their ventilator for more than 16 hours per day. If you have a second ventilator it is recommended that you alternate machines regularly so that both are properly maintained. Consider using one as your day unit and the other as your night unit.

If it is not possible to have a second ventilator available, having a bag valve mask readily available may be an adequate emergency plan (see more on this below).

Alerting carers
Ensure that your ventilator will sound a loud external alarm if there a problem with power supply or the ventilator is not working correctly. Ensuring that carers can hear this alarm is important, especially if the power failure occurs at night. This may require the purchase of an additional loud alarm that can be attached to some types of ventilator. Alternatively, some people use a baby monitor so that alarms (or a call for help) can be heard in other parts of the house: an internal battery should be present in both the receiver and base unit.

It is important to be aware that not all VPAP and BiPAP machines have built in power failure or breakdown alarms so an alternative way to alert carers will need to be in place. A wireless doorbell push or personal alarm system are often used to alert carers that help is needed, but this is only possible if the person has enough arm strength to reach the button and press it. A micro-switch can be added to the wireless door bell button so that it can be activated with minimal pressure.

Alarm

Raising the alarm: Loud external alarm (left) and micro-switch attached to a wireless doorbell push (right)

Preparing for lengthy power failures
Most power failures last only a few hours at most, and back up batteries will be sufficient to cope with this. But occasionally they can last longer so you need to have a plan in place. Which of the following options you include in your plan will be a personal choice based on what you are comfortable with, where you live and your level of dependency on ventilation.

1. Plug in to the car lighter socket using an inverter. The engine must be running in a well-ventilated place (i.e. not in a garage) and you should plan to either sit in the car or have a long extension cord available to run the power to the house. Your ventilator supplier should be able to help you choose a suitable inverter for your device.

2. Use a portable generator which should be regularly checked to make sure it is in good working order. This might be a good option to consider if there is other essential equipment in the house that needs power or you live in a remote location.

3. Head to the nearest hospital which will have generators (call an ambulance if necessary). Alternatively, you may have family or friends nearby who have not lost power that you could go to. Have an evacuation plan in place including a list of what you need to take with you.

Option number 3 is probably a sufficient back-up plan for most people provided well maintained back up batteries are available.

Bag valve mask
A ‘bag valve mask’ (otherwise known as an “Ambu bag” or manual resuscitator) is a hand held device used to provide ventilation in an emergency. Everybody on ventilation should have a manual resuscitator bag valve mask available and all carers properly trained to use it. Dial 000 for an ambulance as soon as possible.

This bag valve mask should also be carried at all times in the wheelchair when away from home.

Register with your power company
Register with your power company as ‘dependent on life support’. This means that they will do everything they can to provide a reliable electricity supply to your house. However, this does not guarantee continuous 24 hour supply, as unplanned power outages occur from time to time for reasons outside their control, such as extreme weather events or traffic accidents. Some companies state that during such power failures, houses registered as dependent on life support will be given priority when restoring supply. The power company will also not purposely disconnect the power from your home (for maintenance or upgrade works for example) without four days’ notice. For this reason, you should make sure they have your up-to-date telephone numbers and contact details.

Registering with your electricity retailer will also make sure you are receiving government rebates that are available to subsidise the electricity used by eligible medical equipment.

Torch and phone
It may sound like common sense, but having a torch handy in case the power goes out is worth including in your emergency plan. A phone – either a mobile or landline – will also enable you to phone the power company to find out when the power is likely to be restored and make any necessary emergency calls. Note: some cordless landline phones do not work if the base station has no mains power.

You should also have important phone numbers to hand such as your doctor, local hospital, family/next of kin, a neighbour and your electricity supplier’s emergency contact number.

Determining the cause of the power failure
Determining the cause of the power failure will help you to decide on further actions to take. Many power supply companies produce brochures on how to do this, for example, this one produced by United Energy. Brochures such as this are often supplied when you register with your power company as dependent on life support.

Once back up power is established and the person using the ventilator is comfortable, a carer can determine if the power is out in the whole house, or if there is a problem with just one power point or one power circuit in the house. A first step is to check whether appliances and lights in other parts of the house are working. If power is available in another part of the house, a fuse may have blown or a circuit breaker been tripped, and a carer may be able to reset this or call an electrician for assistance. If power is out in the whole house, call a neighbor to find out if they have also lost power. A call to your electricity supplier will also give you further information on the extent of the power outage and when it is likely to be restored.

Other equipment
Inevitably people who use a ventilator will also have other electrical equipment that they rely on. This could include:

• cough assist machine
• suction machine
• humidifier
• pulse-ox
• nebuliser
• electric wheelchair
• hoist
• electric bed
• air-conditioning

A plan should be put in place for each of these pieces of equipment as necessary. Some of these will have their own back-up batteries or an alternative can be found. For example, manual suction equipment can replace a suction machine and carers can learn assisted coughing techniques to replace a cough assist machine.

You may also need to consider what you would do in hot or cold weather without power to run air conditioning or heating. People with reduced mobility are less able to cope with heat and cold so you may need to evacuate in this situation for your comfort and health.

Summary
While the likelihood of a lengthy power failure may be assessed as small, the consequences of not being prepared are significant. Do not assume that every carer is familiar with your circumstances. Your preparation will give you the confidence and authority to direct action and choose options that can be acted on by your carers.

Links
DMD Pathfinders in the UK has produced a leaflet called “Life and Breath” which contains examples of emergency plans. Download Life and Breath here.
• The Department of Human Services (DHS) website has general information on preparing for emergencies.

Many thanks to Anne Duncan, Victorian Respiratory Support Service Outreach Coordinator at Austin Health (Heidelburg, VIC) for her help in preparing this document.

For further information on any of the areas discussed above, please contact MDA:
Phone: (03) 9320 9555
Email: info@mda.org.au

 

Updated 09 September 2014