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Chapter 7. Critical care triage. Recommendations and standard operating procedures for intensive care unit and hospital preparations for an influenza epidemic or mass disaster.
- Source :
-
Intensive Care Medicine . Apr2010 Supplement 1, Vol. 36, pS55-64. 1p. - Publication Year :
- 2010
-
Abstract
- <bold>Purpose: </bold>To provide recommendations and standard operating procedures for intensive care unit (ICU) and hospital preparations for an influenza pandemic or mass disaster with a specific focus on critical care triage.<bold>Methods: </bold>Based on a literature review and expert opinion, a Delphi process was used to define the essential topics including critical care triage.<bold>Results: </bold>Key recommendations include: (1) establish an Incident Management System with Emergency Executive Control Groups at facility, local, regional/state or national levels to exercise authority and direction over resources; (2) developing fair and equitable policies may require restricting ICU services to patients most likely to benefit; (3) usual treatments and standards of practice may be impossible to deliver; (4) ICU care and treatments may have to be withheld from patients likely to die even with ICU care and withdrawn after a trial in patients who do not improve or deteriorate; (5) triage criteria should be objective, ethical, transparent, applied equitably and be publically disclosed; (6) trigger triage protocols for pandemic influenza only when critical care resources across a broad geographic area are or will be overwhelmed despite all reasonable efforts to extend resources or obtain additional resources; (7) triage of patients for ICU should be based on those who are likely to benefit most or a 'first come, first served' basis; (8) a triage officer should apply inclusion and exclusion criteria to determine patient qualification for ICU admission.<bold>Conclusions: </bold>Judicious planning and adoption of protocols for critical care triage are necessary to optimize outcomes during a pandemic. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 03424642
- Volume :
- 36
- Database :
- Academic Search Index
- Journal :
- Intensive Care Medicine
- Publication Type :
- Academic Journal
- Accession number :
- 105155127
- Full Text :
- https://doi.org/10.1007/s00134-010-1765-0