When the Power Goes Out and Somebody Depends On It

If somebody who depends on powered medical equipment is in trouble, call 911. Do not spend time troubleshooting the equipment first.

The same outage is an inconvenience for most of a street and a medical event for two houses on it.

A monsoon storm takes the power out for six hours. For most people that is a spoiled freezer and a dark evening. For somebody using an oxygen concentrator, somebody whose insulin is in the fridge, or somebody who cannot tolerate a house at 95 degrees, the same six hours is something else entirely.

This page is for the second group, and for whoever is looking after them.

Refrigerated medication, and the rule as the CDC writes it

The CDC’s instruction, quoted exactly:

“Some drugs require refrigeration to keep their strength, including many liquid drugs. When the power is out for a day or more, throw away any medication that should be refrigerated, unless the drug’s label says otherwise.”

Two things in there are easy to miss. The threshold is a day or more, not a few hours. And the exception is the label — some medicines tolerate time out of the fridge and say so.

And here is our addition to it, which the CDC does not say

Before you discard anything you cannot replace today, call your pharmacy.

That is our instruction, not the CDC’s, and the reason is straightforward: “throw it away” is sound advice about a medicine’s strength and incomplete advice about a person’s week. If the medicine in that fridge is one somebody cannot go without, discarding it with nothing to replace it creates a second problem while solving the first.

A pharmacist can tell you what your specific medicine tolerates, whether the batch is likely to still be good, and how fast a replacement can be arranged. That call costs a few minutes and it is the difference between following a rule and managing a situation.

What we are not telling you to do is keep using a medicine the CDC says to discard. We are telling you to make that call with somebody who knows the drug, rather than alone, in the dark, looking at a cool box.

Powered equipment: the plan is made before, not during

An oxygen concentrator, a home ventilator, a CPAP machine, a feeding pump, a powered wheelchair, a nebuliser, a refrigerated-medicine supply — all of these have the same vulnerability and none of them can be improvised at the time.

The CDC’s power-outage guidance does not cover this equipment, so we are not going to invent instructions for it. What we can say is where the answers actually live:

Your equipment supplier knows the battery life of your device, whether a back-up battery is available, and what the alternatives are. That is a phone call to make on a calm afternoon.

Your prescriber knows what happens clinically if the device stops, and for how long, and that is a conversation worth having once rather than never.

Your utility may run a programme for households with medical needs — worth asking whether one exists and how to be on it. We are not going to tell you that it does; we are telling you it is worth the question.

And somebody outside the house should know. A neighbour or a relative who knows that this address has a person dependent on power is the fastest help available in a long outage.

If the device has stopped and the person is in difficulty, that is 911. Not a call to the supplier, not a search for the manual.

In Arizona, the heat is the second problem and it arrives fast

An outage in July is a heat event with a delay built in. The house is fine, then it is not.

A few hours of air conditioning somewhere else genuinely helps — the CDC’s own advice is a shopping mall, a public library, or an air-conditioned shelter, and it says “even a few hours spent in air conditioning can help.” It also suggests cool showers or baths, which work without electricity.

The full version of that is on where to cool down when the house will not, including the state’s own cooling-centre locator.

And whoever is most vulnerable to the heat is usually the same person most vulnerable to the outage. Older adults, infants, anybody on medication that affects how the body handles heat. Those hours are not a nice idea for them.

Do not solve a power problem with a combustion problem

A generator, a charcoal grill, a gas range used for warmth, or a car running in a garage can kill a household faster than the outage will. The CDC’s rule is twenty feet from any window, door or vent, and never inside a home, basement or garage.

The reason this matters even more in a medically vulnerable household: the symptoms of carbon monoxide poisoning overlap almost completely with heat illness, and that overlap has its own page.

The food numbers, since everybody asks

From the CDC, and they are more generous than people assume if the doors stay shut:

• A full freezer keeps food safe for 48 hours — “24 hours if half-full” — “if you don’t open the door.”
• A refrigerator keeps food safe for up to 4 hours, again if it stays closed.

Four hours is the one that surprises people, and it is the reason a fridge is the wrong place to keep checking on things during an outage.

When to come in

Call 911 for anybody in respiratory difficulty, anybody who is confused or cannot be roused, anybody whose equipment has failed and who is deteriorating, and anybody you are frightened about.

Come to an emergency room for somebody who has missed essential medication and is becoming unwell, for heat illness that is not settling, for anybody with a chronic condition who is going backwards during a long outage, or where you cannot tell what is happening.

Our emergency rooms are open every hour of every day and are walk-in, with CT, X-ray and a full laboratory in the building — and they have power. Go to the nearest one, and if another emergency department is closer, that one is the right answer tonight.

If you are unsure, come in — this list is not exhaustive and you are not expected to manage a medical dependency during an outage on your own.

Questions people actually ask

My insulin has been out of the fridge for eight hours. The CDC’s threshold is a day or more, so you are inside it — and call your pharmacy anyway, because they can tell you about your specific product and its label. Do not discard something you cannot replace before you have made that call.

The power has been out for two days. Then the CDC’s rule applies to anything that should have been refrigerated, and the pharmacy call becomes urgent rather than sensible. If missing it would make somebody unwell, that is a reason to be seen rather than a reason to wait.

How long will my oxygen concentrator’s battery last? Your supplier knows and we do not. If it is running low and the power is not back, treat it as an emergency rather than a logistics problem.

Is a fridge full of medication a reason to go to an emergency room? The medication question is a pharmacy question. Becoming unwell because you have missed medication is an emergency room question. Those are different, and the second one is why we are open.

Nobody in my family needs anything special. Why is this page here? Because most people reading it are looking after somebody who does, and because the neighbour who knows is the thing that makes a long outage survivable for that household.

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Call your pharmacy before discarding anything you cannot replace, make the equipment plan on a calm afternoon, and call 911 if somebody dependent on power is in difficulty. Both of our emergency rooms are open 24 hours a day, every day of the year — walk in, no appointment and no referral. Find your nearest emergency room →

Related reading: where to cool down when the house will not · carbon monoxide after a power cut

Sources

36. What to Do to Protect Yourself During a Power Outage — Centers for Disease Control and Prevention. https://www.cdc.gov/natural-disasters/response/what-to-do-protect-yourself-during-a-power-outage.html

This article is general information, not a diagnosis, and it cannot account for your medicines or your equipment. If you are unsure, come in — this list is not exhaustive. If it might be an emergency, treat it as one and call 911.