One of the biggest concerns I had when I was considering home hemo and which I, in fact, still have today is the possibility of an emergency during dialysis and how I would deal with it.
Recently, I came across EMRI, or the Emergency Management and Research Institute set up in my state and other states in India. You basically call 108 from a telephone and an ambulance equipped with medical emergency handling equipment and a qualified person picks you up and rushes you to the nearest hospital.
This came as a huge surprise. I was not aware of this at all. This is quite comforting as you now know that there is a backup that is available should something go wrong. I am not sure if the person in the ambulance is equipped to handle emergencies arising out of dialysis. But he is usually aware of the treatment to be administered to handle cardiac arrests, strokes and some other emergencies.
A very good first step.
During the initial days of my starting home hemo, there were quite a few instances where my blood would leak around the exit site. I wouldn't classify this as an emergency that required me to be rushed to a hospital. This too stopped after I started tying my arm with the fistula with a string to my bed so that the movement was restricted. With nocturnal dialysis, the chances of an emergency are generally lower than with hospital hemo because of the gentle nature of the treatment. However, the risk is not eliminated and having this kind of a fallback is quite reassuring.
There is also an extension to this facility. You have an option of installing a button at home which when pressed, automatically calls the call center and they get the location details automatically. This way an ambulance can be send much sooner to your house.
This is indeed a giant leap for emergency medical care in India.