Emergency Kit, Go-Bag, BOB (Bug Out Bag)

@wadawabbit , @Dennis , @joe

One of my “other duties” is distaster preparation. There have been issues all over the USA in regard to disasters, evacuations, floods, storms, wildfires, and the list goes on. In another social group the question of what do you put in an Emergency Kit, Go-Bag, BOB (Bug Out Bag). This list has been fince tuned by endo’s, paramedics, pumpers, CDCES (fka CDE), & disaster emergency shelter managers.

Currently, there is development off the coast of northern South America with the potential for SE USA impact in the next 10-15 days.

GO-BAG
INSULIN PUMP USER’S EMERGENCY KIT

Work with your pump trainer & doctor for this kit’s inventory. Below is emergency kit inventory & you should plan enough for 30-day evacuation. Check contents monthly.

  1. BG testing supplies: meter, strips, lancets, batteries, and control solution.
  2. Fast acting carbohydrate to treat low BG.
  3. Extra snack for longer coverage that fast-acting carbohydrates including protein, & fat.
  4. Glucagon emergency kit or equivalent – minimum 2.
  5. Ketone measurement supplies – if history of elevated ketones or MD advice.
  6. Anti-emetic drug of choice (what you and your pump team believe best).
  7. Anti-nausea and/or other drugs (what you and your pump team believe best).
  8. Non-latex gloves – 10 pair & N95 masks – 10 each.
  9. OTC meds: NSAIDs, triple antibiotic ointment, (what you and your pump team believe you may need).
  10. Rapid-acting insulin & syringes or insulin pen & needles. (Enough for 30 days)
  11. Long-acting insulin & syringes or insulin pen & needles. (Enough for 30 days)
  12. Charging gear and/or batteries for 30 days.
  13. Insulin pump – spare parts (port covers, battery caps, etc.)
  14. CGM sensors . (Enough for 30 days) (rotate after acquisition of new supplies)
  15. Spare CGM transmitter (rotate after acquisition of new supplies)
  16. Pump packs – everything you use for a POD or cartridge & site change in a Ziplock® sealable plastic bag (Enough for 30 days)

a. PODs or infusion set &
b. Insulin pump cartridges
c. Syringe & needle used for cartridge filling
d. Skin prep supplies - alcohol swabs and skin preps
e. Site dressing
f. Tongue blade

  1. Diabetes medical alert identification or jewelry (should be wearing/carrying)
  2. Insurance card(s) – also copy in phone’s photos or electronic wallet.
  3. Surgical marker or “Sharpie®” pen to mark location of a lost CGM wire, etc.
  4. A list of current medications (both brand & generic names) including dose and when taken. Your pharmacist can help with this and possibly provide a document to get medications filled away from home in an emergency.
  5. A list of your emergency contacts, including address, telephone, & email.
  6. PROTOCOLS for managing pump, sites, hypoglycemia, and hyperglycemia - including on & off pump instructions and supplies.
  7. Tape &/or over-patches used to secure pump sites & CGMs
  8. Blade razor to remove hair if needed to prepare a site for pump or CGM.
  9. Power block or other USB power source to recharge pump if electricity is out.
  10. Gauze pads to hold pressure or cover bleeders.
  11. Stain removal pen(s) to remove blood stains from bleeders, etc.
  12. Flashlight
  13. Any other items you and your pump team believe helpful.

Consider a weatherproof case like the Pelican iM2450 Storm Case or the Harbor Freight Apache 4800 Weatherproof Case for egress in hostile weather situations.

RATIONALE:

Why 30 days. There have been several disasters (floods, wildfires, earthquakes, hurricanes, etc.) or similar events in the recent past in the USA and globally where evacuations and other circumstances have necessitated rapid relocation. This list has been made in consultation with endocrinologists, CDECS, pump trainers, nurses, paramedics, and disaster shelter managers.

PUMP SETTINGS & INSULIN DOSING

Pump settings for morning, noon, & evening (consider printout from your data website like Diasend, Tidepool, tConnect, etc.)
[a] Basal
[b] insulin to carb
[c] correction factor AKA
Insulin sensitivity

Thoughts?

Thanks so much @987jaj . You know about these things in the back of your mind but it helps to spell them out in great detail.

On the topic of off pump instructions - I had an issue with my pods a few days ago and thankfully it was resolved; but it did beg the question: if I had to go back on shots temporarily, are my injection instructions up to date? I have pens but it’s been a while since I’ve reviewed those instructions and it’s very possible that my basal needs have changed and I need to update them. All of which is to say, be sure to keep your instructions available and note the “as of” or “last reviewed” date so you know you’re current. Maybe review them at each endo visit - something I need to do myself.
On a side note, Medic Alert has a Smart ID card with a QR code you can scan for your health record, including your medication list (be sure to keep it updated). I keep mine in my wallet with my license - don’t know if emergency services would know to scan that if the need arose, but it’s very helpful for self use.

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@987jaj , I think the list is comprehensive.

I think, for pump users, the pump catastrophe backup for example I am a long time pump user so I maintain a second “off warranty “ pump in my bag AND I have a bottle of lantus. This gives me security and flexibility in case things go sideways.

Very timely for me J @987jaj as according to the latest NHC timeline, the eye of the storm will pass directly over me sometime Tuesday into Wednesday. Battery packs all topped up, including the solar charger which is on the sunny lanai right now. Thanks for posting; I’m going to “pin” this Topic so it remains visible at the top for a while.

This is a good addition Dorie, and is OK as long as electronic communications remain open, but would have been useless 5 years ago last week in my area. What I have is the MedicAlert EMI sheet [available on the MedicAlert page] printed out and with me at all times - it folds and fits right in my wallet with my insurance card and driver’s license. On the obverse of the sheet, I have printed contact information for ALL my doctors, Tandem and Dexcom contact numbers.
The printed form is immediately available under all circumstances and comes in handy for other purposes.

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@wadawabbit , thank you for you kind reply.
Reference: " PROTOCOLS for managing pump, sites, hypoglycemia, and hyperglycemia - including on & off pump instructions and supplies." The initial list of items was take from the “items to have” on several pump manufacture’s lists including Tandem, the defunct Animas, Medtronic, etc. It is our responsibility to have a pump failure plan available at all times.
Reference: “Diabetes medical alert identification or jewelry (should be wearing/carrying)” the items from Medic Alert Foundation are great. Yes, EMS is taught to scan the QRC on the cards or IDs.
@Joe:
Reference: “maintain a second “off warranty “ pump” for emergencies has been run around and around until the fur has been beaten off of the dog. It is a workable idea IF & ONLY IF, the pump settings are current. Otherwise, resorting to MDI may be safer. The status of pump settings is one reason Tandem gives for not having a ‘programming’ option in tConnect to program an in warranty pump exchange - - the settings in the server may not be current and could be harmful. Lawyers got this one.
@Dennis
Reference: “according to the latest NHC timeline, the eye of the storm” is the main reason this was put up. There have been 1000 year floods near me in Eastern Kentucky, hellacious wildfires in the western USA, to name a few. The time was right.
A hard copy of the Medic Alert EMI page in the package would be grand. Technology fails.

Outside comment:
REFERENCE: “A list of current medications (both brand & generic names) including dose and when taken. Your pharmacist can help with this and possibly provide a document to get medications filled away from home in an emergency.” The comment was made to have current paper prescriptions. The practice of printed prescriptions handed to the patient or filled by local pharmacies is drawing to a close according to most sources. There have even been documented social media posts of insulin pumpers asking for ‘backup scripts’ being told the state (later verified) does not allow them & instead mandates E-Scripts, etc.

SEMANTICS:
Some commenters in multiple sites across the social media world have discussed the various names for the kit.
The names for the bag have come from a myriad of sources and are for all intents and purposes deemed to be interchangeable and semantically equal. The names originated with the following classes of contributorsd:
Insulin pump manufacturers
Endocrinologists (USA, Australia, European Union, UK, KSA, Egypt, & Canada)
Diabetes Educators, Physician Assistants, & Nurse Practioners
Paramedics & EMS responders (USA, European Union, UK, KSA, Canada)
Red Cross & USA FEMA evacuation shelter managers

With the input of the above, the following are seen identical, interchangeable and semantically equal.

Insulin Pump Emergency Kit, Go-Bag, or BOB - Bug Out Bag

It is my hope all can be tolerant of this endeavor to help and not confuse or initiate word wars.

@987jaj thank you so much for sharing this important much.
@Dennis stay safe! Keep us posted on how you’re doing.

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Thanks for this, @987jaj . I don’t live near hurricanes (except for defanged ones), wildfires, landslides, tornadoes, the kinds of floods that hit Kentucky earlier - any of that. Blizzards and ice storms, yes, but I’ve yet to experience one that called for bug-out-bags, not even the worst. Doesn’t mean I shouldn’t have one.

But I do have a question that’s been bothering me for awhile. Decades. If I woke up to a fire alarm in the middle of the night - a time at which I am NOT known for being human nor as intelligent as a dust mite - would I know what to grab as I try to run out as fast as possible? (Answer: NO, grabbing wouldn’t even occur to me.) Never mind remembering to collect insulin from the fridge. I am horrifically afraid of fire.

I do try to mentally rehearse, semi-regularly, before bed: OK, pills are here, diabetic supplies here (close to each other and scoop-uppable), remember to grab the Contour Next meter and phone here (next to the bed), but the fact is I’d be totally insane. I’d be clawing to get as far away from the house as I could before it ever occurred to me what I was running from, let alone to collect anything at all - bug-out-bag, shoes, coat in a blizzard, none of it. Phone with all my diabetes apps on it.

OK, I should prepare my bug-out bag, but I’m still not quite sure how to prepare to remember it. Do I need to start doing weekly dry runs, or something??? I think dry runs would do anything else than comfort me. How does one prepare for wild, mindless terror? Oh, man, I am shuddering. I foresee nightmares tonight.

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@theNoz , you raise a great “what if?”
Ideas:
(1) as far as computers & important paper, scan papers & have on 2 different servers in addition to at home. Includes pictures from negatives, etc.
(2) Go-bag near primary residence exit including ALL pump supplies with insulin. Room temperature seems good for long periods.
(3) Historical disasters are not the only issue. Urban disasters (plane crash, gas line calamity, hazmat incident) are not projected by history.
are the expanded situations noting preparedness.

Thank you.

Stay safe

Hi @theNoz I heard that no plan survives contact with an emergency. Planning and Practice makes for a more orderly response but if the emergency is not what you planned, it is important not to panic. In a fire you leave (period) you don’t have time to grab things. A comprehensive fire smoke and carbon monoxide detection system and preventative maintenance for combustion heaters and clothes dryer in the dwelling, along with a scheduled battery change for your detectors is crucial. Given that a fire would most likely be a local event, you can always go to your pharmacy afterwards. :grinning: best of luck, may you never have to test your plan :shamrock:

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@987jaj , Thanks for suggestions. It’s a little harder than that - for instance, my main entrance is hemmed directly on one side by the bathroom door, on the opposite side by the stove, and in front by the kitchen sink and a whole foot (woohoo) of counter. I make an excuse for squeezing the trash in next to the counter, but bump into that when the kitchen is dark.

It’s a very small, attic-y apartment. There are similar problems regarding temperature control, so I really don’t want to leave insulin out during summer months.

But it occurs to me to hang a hanger on the bathroom door hinge that has a hook that can hold the go-bag (can’t put in new hardware, like a hook). It’ll be in the sun every morning, that’s a problem, but it would be there.

@joe, Thank you for the note on plans not surviving contact with emergencies. Yep, got the smoke and carbon monoxide alarms just minimal recommended distance to the stove and gas heater respectively. It’s basically only 2 rooms, 325 feet but I could be convinced to put in another smoke alarm. My sister doesn’t tend to change the batteries in hers, downstairs, so I am self-designated battery changer for her whole house. I am nothing if not neurotic about fire. :-T Lucky for my nerves, she doesn’t even ever use her clothes dryer.

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Hi @theNoz . Thankfully I haven’t had any emergencies as we’re addressed here, but here’s a thought if you are ever forced to evacuate: from what I’ve heard following emergencies, in some situations residents are allowed to return to their home - presumably with supervision - to get medication and essentials. If that’s not the case, So all may not be lost. If not, I would reach out to my pharmacy to see if they can give me early refills. My pharmacy has occasionally advanced me a few tablets, or gotten an insurance override to fill my insulin a few days early when I ran short. The number of overrides may be limited under normal circumstances, but in the event of a catastrophe they may be able to press things with your insurance. Contact your insurance on your own as well. And your doctor may be help you get refills or provide samples to last you…
I keep some pump supplies in my desk at my office - a couple of pods now (previously tubing and cartridges), and my old office I kept a spare bottle of insulin in the department fridge (I put it in an old rx pill bottle with my name on it) although now with Omnipod I carry it with me.
Another option would be to keep non-perishable kit items in your car, although I don’t know about temperature limitations. I imagine unless they were being evacuated onto an emergency bus or boat, that’s probably where people would head.

Thanks, Dorie. I don’t have an office, but stuff in the car, check. Really, I’m mostly worried about the mindless, crazed fear, and I guess partly what the heck is going to become of my blood sugars in that first hour, two?, five? as a result. Going to the pharmacy is great if they’re open, and there’s the ER if they aren’t, but that’s not a solution. (“And the car will go up with the house,” my mind nags.)

Keeping my head is the best solution. And yeah, @joe has the best point: Planning I got, but Practice, Practice, Practice. But - ugh, shudder. Fire… Fire is wholly outside the realm of sanity. Fire is…

35 years ago the woman I shared an office with believed that I was a reincarnation of a witch who was burned at the stake, and/or burned in Mrs. O’Leary’s fire or the Great Fire of London, and/or someone who was burned by trying to run from lava that I couldn’t escape in the end. She was no help at all.

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@wadawabbit , the correct dosage of insulin in a pump failure is some thing we all need to have from our endo’s. There are formulas for using the total basal for a 24 hour period and giving a percentage of the total basal. One reason for using a percentage instead of the total is POD 5 & Tandem CIQ throttle basal every few minutes according to an algorithm. Daily insulin basal for this reason may vary.

This variation is the reason to ask & know.

Your comment about knowing the “as of” or “last reviewed” date is one of the reasons to review the entire BOB every 30 days. Charge the power brick while reviewing the other contents for dates and status.

As far as Medic Alert’s SMART Card, EMS will look for jewelry. However, your wallet, licensee, etc goes with law enforcement instead of EMS. Some of the newer IDs don’t even have the “Star of Life” on them. They are cute but not recognized in EMS training materials.

In reading about your living space, copying your post, “my main entrance is hemmed directly on one side by the bathroom door, on the opposite side by the stove, and in front by the kitchen sink and a whole foot (woohoo) of counter. I make an excuse for squeezing the trash in next to the counter, but bump into that when the kitchen is dark. It’s a very small, attic-y apartment.” makes me ponder. Would your residence pass fire code?

This is off subject. Unwritten here is an implied rule, SAFETY.

See private message.

I expect the best and prepare for the worst, and having always done that is easy for me to say while it may be very hard for you to do. But even when pondering "what’s the worst that can happen " I imagine things that are more in the realm of possibility as I see them. Could my car “go up”? Possibly, but not likely. And if it does I trust myself to find a way to do what I need to do. The pharmacy may be closed in the wee morning hours - unless you have a 24 hour one - but that’s not for immediate needs (which would be in your kit) but rather for “re-stocking.”
If you’re on shots and need to inject before you can get to your pharmacy, that’s all the more reason to train yourself to keep a cool had so you remember to grab your pens. If you don’t have an office ask a nearby friend of you can keep your emergency stash at their place. Think about creative things you can do to have what you need.
Having diabetes has taught us to be both anticipatory and responsive: let’s face it, sometimes things happen despite our doing what we’re supposed to, and we have to manage it. Hopefully that can help you trust yourself which in turn can teach you to keep a cool head if an emergency arises.
There are lots of things that make up who you are. I myself am a worker, a wife, a pet lover (and unashamed spoiler), a guardian, a person with Type1 diabetes, a person who loves to write, a daughter - my list goes on and on and I’m sure yours does too. One thing that does NOT belong on your list though is what your office mate from 3 decades ago said. She was not only no help, she was and is a hindrance. She has burrowed into your psyche and it sounds like she is the cause of your level of fear. Fire is certainly frightening, and no one wants to be in one. But people do escape and are not in effect burned at the stake. If you need counseling to get that idea out of your head, please get it so you can respond calmly and rationally in the hopefully unlikely event you ever find yourself in the situation.

@wadawabbit , my old office mate is not the source of my neuroses about fire. She just partly makes a good story and partly is very descriptive of my level of neurosis about fire. I’ve been thinking back and back, and I was this fearful of fire as far back as I go. 4 years old, anyway.

And to @987jaj , we do pass this state’s inspection laws. I have my doubts about whether it would wholly pass Massachusetts laws, where I came from, at this point. I wound up with 8 smoke alarms and 3 carbon monoxide alarms for my 6 room house in Massachusetts. I had moved in to only 2 smoke alarms, and installed 4 more, but even in the 9 years I was there the laws changed so much (I guess) that as I say, to sell it I needed 4 times as many as it was sold to me with. Or maybe I got an inspector on his bad day.

I didn’t have a go-bag there, though. Again, I’m really glad for this thread.

@Dennis - Good luck. I have several friends and a cousin scattered around Florida like freckles, and with “Ian” it feels like I lose track of which of them is my biggest concern as the storm seems to constantly change predicted course as soon as anybody decides they know what it’s going to do. Stay safe!

Is there an emergency list for a MDI user ?

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@Jophilly , You have asked a great question. The only difference I can see in the pump list and a list optimized for MDI users would be the absence of the pump supplies specifically.
[1] you still want 30 days of supplies to support your MDI
[2] if you use a meter & or CGM, support for 30 days, including power features & supplies (strips, lancets, CGM sensor, CGM transmitter, overpatches, alcohol wipes, etc)
[3] snacks, both the rapid carb and protein-fat sustaining snacks
[4] everything else is supportive

see private message.

Hope this helps - thoughts?

This is great, wow, Thank You so Much! I have printed this and I’m putting it in my kitchen cabinet 1) to start working on the list and gather the items, and 2) for emergencies it’s great to have this list for a quick view. THANK YOU for your time!

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