7-03/090.15 Transportation for Hemodialysis

The basic responsibility of maintaining custody of inmates is of paramount importance, however, there are certain medical facts that must be considered when transporting inmates for hemodialysis treatments:

• When an inmate is undergoing treatment on the dialysis machines body functions are greatly decreased. If the inmate were to try an escape attempt, profuse bleeding would result, and the possibility of death would occur within three to five minutes.
• While undergoing treatment, the chance of cardiac arrest increases greatly. If cardiac arrest occurs, the medical staff must move the inmate/patient from the treatment chair to the floor, for immediate cardiopulmonary resuscitation.

Because of medical necessity, the following procedures will be adhered to:

• Inmates will be secured with chains and/or handcuffs going to, and returning from the dialysis center, in accordance with existing Department and Bureau policies.
• It is not necessary nor desirable, to handcuff or leg chain  an inmate who is in the treatment chair undergoing dialysis treatment, except under the following conditions:
  1. The inmate is a high escape risk.
  2. The dialysis center requests to have the inmate restrained.
  3. The Deputy is aware of extenuating circumstances that justifies handcuffing.
• Inmates are not to be chained to the hemodialysis chair or bed.  
• If a disagreement arises between the transporting Deputy and the medical staff about restraining an inmate/patient, the Watch Sergeant shall be immediately notified and will resolve the conflict.

When transporting an inmate for dialysis treatment, transporting personnel should have in their immediate possession a pair of rubber gloves. A large percentage of hemodialysis patients also have hepatitis.

Bleeding is a common occurrence for individuals suffering from kidney failure, particularly after being dialyzed. Due to the possibility of contracting hepatitis from the blood of an infected individual, rubber gloves should always be worn if the necessity for first aid arises. It is also a good idea to wear rubber gloves during chaining and unchaining.

The medical staff at the hemodialysis center will fax to Men's Central Jail Medical Clinic/Sybil Brand Institute Medical Clinic all doctor's orders, prescriptions, or medical forms pertaining to the inmate/patient.  

When an inmate refuses dialysis treatment, the inmate shall be returned to the Inmate Reception Center at Men's Central Jail or Sybil Brand Institute, as soon as possible. The transporting Deputy shall notify the Transportation Bureau Watch Commander and the Men's Central Jail/Sybil Brand Institute Clinic Supervisor, of the refusal.