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It's a growing population. Roughly 2 million people use home oxygen machines, mostly "concentrators" that make oxygen on the spot as long as electricity flows. Just a few years ago, oxygen-gas tanks that don't require home electricity were the norm.
At least another 10,000 people breathe with home ventilators, and thousands more have implanted heart pumps called VADs, or ventricular assist devices.
There even are a few remaining users of those body-encasing iron lungs infamous from the polio era. Moore counts 19 in Houston-area homes. Last May, a Tennessee woman who spent nearly 60 years in an iron lung after childhood polio died when the power went out and her family couldn't get an emergency generator working.
Millions more use other at-home equipment: dialysis machines, nebulizers, IV and nutrition pumps, CPAP breathing masks. But power failures bring the most immediate risk for users of ventilators, heart pumps and oxygen.
Ventilators and heart pumps have internal batteries that last 45 minutes to a few hours, time to put on longer-lasting batteries or get to help. Some portable oxygen concentrators can run on batteries for three or four hours or be plugged into a car adapter, but patients typically depend on oxygen suppliers to deliver old-fashioned tanks of the gas for emergency use.
No one knows how often a power outage means death for such patients. Typically, death certificates note just the underlying disease, said disabilities specialist Lex Frieden of the University of Texas at Houston, who tried to track down the power-dependent during Ike's prolonged outage to see who needed help.
Backups sometimes fail even in short outages.
Last summer, 15-year-old Fernando Vargas died when a Boston power outage silenced his ventilator early one morning.
When the power went out in Carpentersville, Ill., the implanted pump powering Jack Bostwick's heart stopped, too, a week after the 60-year-old's optimistic discharge from the hospital in May 2007. The device's internal emergency battery somehow had dislodged, apparently giving him no time to insert longer-lasting ones. His family asks why Bostwick, newly registered on the utility's critical-care list, wasn't warned about a planned outage for pole repair. The utility declined comment because of a pending lawsuit.
But long outages are the big threat because batteries don't last and oxygen tanks need repeated refills.
"I thought I was prepared," said Houston's Kristin Graham. Before Hurricane Ike, she readied a generator, gasoline and rechargeable batteries that could run son Gatlan's ventilator for six to nine hours on a charge, and his oxygen machine for another few hours.
But the outage lasted so long, Graham said, "We couldn't afford to buy the highest-powered generator on the market. You can't run that generator 24 hours. You run it a couple of hours, you let it rest a couple of hours. I could never get all the batteries recharged."
Graham signed up for her utility's priority list and Houston's 211 emergency service, but said no one checked if she needed aid. Ultimately she loaded Gatlan, his medical equipment and his 4- and 8-year-old siblings into the family van and checked into a hotel room, first in a less hard-hit Houston area and later in cheaper Austin, to get electricity.
"I don't know what people would do if they didn't have a way to get out on their own," she said. "No one cared this time if you were on a critical list. They couldn't. It was too broad."
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The 2003 Northeast blackout, the nation's largest power failure, was a wake-up call for New York City's Prezant. In a study published in the journal Critical Care Medicine, Prezant tracked citywide 911 calls plus emergency room visits at his own large hospital, Montefiore Medical Center, during the nearly 29-hour blackout. Continue »
