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Tips for Surviving the New Millennium

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Duke Health News 919-660-1306

Like a Hurricane

While the idea of a Y2K computer bug may seem a nebulous concept to prepare for or understand, Duke emergency physician Dr. Kathleen Clem has a much simpler approach:

"Prepare for it just like you would an impending hurricane," said Clem, chief of emergency medicine. "We advise people to go through their house and make sure they have water, medicine refills, gasoline in the car, food and other supplies like flashlights or candles.

"In most disaster situations, one of the biggest problems people face is unexpectedly running out of the necessities of life," she continued. "During these time, emergency rooms often deal with these non-medical issues - people are hungry or cold or out of medicine and we're the only place that's open. In the last hurricane, lots of people came here from a lack of planning ahead, not for medical reasons."

Clem said Duke officials have been planning for Y2K and are confident Duke's Emergency Department will be able to handle any unexpected interruptions in power or computing capabilities.

"We've stocked up on extra medications and supplies, and we have additional doctors and nurses on call with multiple ways of reaching them," Clem said. "We have generators and back-up heat and water. And even if we lose computer power, we have a system for keeping medical records by hand without computers."

The bottom line is that the Emergency Department will be open, fully staffed and prepared to handle whatever medical emergencies may arise.

"I honestly think people should just stay at home New Year's Eve - they're less likely to have a bad problem than if they're out and about," Clem said. "Act just like you would for a hurricane."

Heart's Ease

As the clock passes midnight on New Year's Eve, people with pacemakers or implanted defibrillators can focus their attention on having a good time without worrying their devices will quit.

Cardiologist Dr. Robert Sorrentino, who directs Duke's pacemaker program, has heard over the past few months many half-joking, half-serious comments from his patients about whether or not their pacemakers will quit at the stroke of midnight. He's been telling them not to worry and enjoy the new year.

"No pacemakers or defibrillators should be affected in their delivery of therapy because of Y2K," Sorrentino said. "All of them should continue to operate properly. The companies who produce these products are very computer savvy, and they've anticipated this situation for years."

The three main companies that make these devices all have websites where patients can get more information about their particular device. They are: Guidant Corp - www.guidant.com; Medtronic Corp. - http://www.medtronic.com/us-en/index.html; and St. Jude Medical - www.sjm.com.

The data-collection function may be affected in some older models of these devices, but Sorrentino emphasizes this has no effect on the actual performance of the device in controlling the heart's rhythm. The data collection capability can be easily corrected by computer programmers during regular clinic visits, he said.

Pacemakers provide support to the heart by producing electric pulses that keep the heart from pumping too slowly. Defibrillators act like a pacemaker, with the added capability of correcting life-threatening fast heartbeat problems.

Keep Cool - Don't Worry About Medications

A little preparation and a bit of common sense should ensure that if anything happens to the electrical supply or computer systems in the new millennium, there should not be any problems with medications.

Pharmacist Leslie Mackowiak, who headed the Y2K compliance efforts in Duke's pharmacy, has the following tips for people and their medications:

"We tell people to keep all their medicine bottles with their labels so that if for some reason their pharmacy's computer does go down, they've got all the information right there," Mackowiak said. She also recommends maintaining a detailed list of all of the drugs being taken by family members.

Don't hoard medications. Mackowiak said that the pharmaceutical industry, wholesalers and retailers have been anticipating Y2K, and have been monitoring everyone's purchases for months. This monitoring has ensured that no one is hoarding excessive amounts of drugs. The pharmaceutical industry typically operates with a 90-day supply in the distribution system, and already has made contingency plans should there be weather or transportation problems.

Individuals should refill their prescriptions when they have a five- to seven-day supply left, Mackowiak said.

If the power does goes out, most drugs - such as insulin or antibiotics - will maintain their effectiveness for a few days at room temperature in a cool, dry place, Mackowiak said. People who have specific questions regarding drug storage should call their pharmacist.

Keep records of all insurance claims and carry current insurance cards with you.

Duke Hospital Readiness

People who must come to the hospital during New Year's or are a patient at Duke shouldn't worry about the transition.

The process to convert basic clinical systems to be Y2K compliant began in 1989 at Duke Medical Center Information Systems. This work intensified during the past year when more than 1,000 computer experts, technicians and engineers worked throughout the health system to check computers, patient-care equipment and other systems for potential problems.

Critical medical equipment within Duke Hospital has been tested and determined to be Y2K compliant. This equipment includes such items as diagnostic equipment, intravenous (IV) infusion pumps, respirators, machines that monitor a patient's vital signs, equipment used in surgery such as heart-lung machines, X-ray and other imaging equipment.

To deal with the unexpected, each area within Duke Hospital has completed a Y2K contingency plan similar to its plan for reacting to a severe weather situation or disaster that could cut power and other community services.

If the power supply is interrupted, the emergency power generators for Duke Hospital have enough diesel fuel to run seven to 10 days. There is enough therapeutic oxygen underground to last three weeks. The hospital has slowly been accumulating medications over the past year in the event of distribution problems. Inventories of food will be about 5 percent higher.

On the night of Dec. 31, the hospital will be staffed as if it were operating under its severe weather plan. A command center in Duke Hospital composed of senior management, physicians and other key officials will be on hand to deal with whatever issues might arise. The command center will be in contact with its counterpart on the university side, as well as with other locations throughout the health system.

Other Hints for Smooth Transition into the Next Century

Communications: Use telephones and the Internet only as necessary on Jan. 1. "Testing" the systems to see if they work or engaging in long conversations could create delays greater than those experienced during high volume usage periods such as Mother's Day.

Financial: If you decide to withdraw cash, hold only as much as you would for any long holiday weekend. Withdrawing large amounts of cash is unnecessary and may invite theft. Financial institutions are well prepared for the date change and there is usually more than one payment option, such as checks, credit cards, debit cards and traveler's checks. Firms that operate automated teller machine (ATM) networks have established aggressive programs with rigorous testing to make sure ATMs will work normally on Jan. 1 and after. While most ATMs are expected to make a successful transition to the new year, temporary disruptions in ATM service are not unusual and may not be Y2K-related. In addition, the Federal Reserve has taken steps to make sure that financial institutions have sufficient cash available at year's end.

Food: Consumers should know that any problems resulting from Y2K should be minimal and manageable, says the Food Marketing Institute (FMI), which represents food retailers and wholesalers in the United States and around the world. Shopping patterns suggest that, on average, consumers purchase food items on a weekly basis, which typically covers weekly meals and monthly household and personal needs. As long as these normal shopping behaviors continue, food shortages should not occur, the FMI says. Typically, most stores have some level of "safety stock" of nonperishable items in back rooms and warehouses at any given time, which is more than adequate for the new year. But the institute says that households should always be stocked with such basic products as toilet paper, candles, batteries and matches.

Home appliances: Most appliances and consumer electronic systems in use around the home do not keep track of the year date to operate effectively and should not be affected by the Y2K issue, says the Consumer Electronics Manufacturers Association (CEMA). Refrigerators, ovens, microwaves, coffee makers, television sets, smoke detectors, washers, dryers and alarm clock radios should not have difficulties with the date change.

Televisions and VCRs: According to industry groups, consumers should not experience Y2K problems with common household electronic products like televisions because they do not use a month/date/year calendar function. However, according to CEMA, a small percentage of VCR models may experience Y2K problems. On some VCRs, you may be able to manually re-set the year to 2000. For others, generally pre-1988 models, recording future events may not work, but you should still be able to continue taping off the air and viewing pre-recorded tapes.

Thermostats: The overwhelming majority of thermostats will encounter no Y2K-related complications because thermostats use chips that keep track of cycles rather than dates. However, some home thermostats with advanced calendar functions that allow consumers to program temperature settings months in advance could be affected by the Y2K issue. If you are unsure about your thermostat's Y2K status, check with the manufacturer.

Travel: The State Department provides country-specific information to travelers through consular information sheets and, in some cases, travel warnings. Consult or your travel agent for more information.

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