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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.
Intensive Care Med. 2010 Apr; 36 Suppl 1:S55-64.IC

Abstract

PURPOSE

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.

METHODS

Based on a literature review and expert opinion, a Delphi process was used to define the essential topics including critical care triage.

RESULTS

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to deliver; (4) ICU care and treatments may have to be withheld from patients likely to die even with ICU care and withdrawn after a trial in patients who do not improve or deteriorate; (5) triage criteria should be objective, ethical, transparent, applied equitably and be publically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.

CONCLUSIONS

Judicious planning and adoption of protocols for critical care triage are necessary to optimize outcomes during a pandemic.

Authors+Show Affiliations

Division of Infectious Diseases and Critical Care, Department of National Defence, Canadian Forces, Mount Sinai Hospital, University of Toronto, Toronto, Canada.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Guideline
Journal Article

Language

eng

PubMed ID

20213422

Citation

Christian, Michael D., et al. "Chapter 7. Critical Care Triage. Recommendations and Standard Operating Procedures for Intensive Care Unit and Hospital Preparations for an Influenza Epidemic or Mass Disaster." Intensive Care Medicine, vol. 36 Suppl 1, 2010, pp. S55-64.
Christian MD, Joynt GM, Hick JL, et al. Chapter 7. Critical care triage. Recommendations and standard operating procedures for intensive care unit and hospital preparations for an influenza epidemic or mass disaster. Intensive Care Med. 2010;36 Suppl 1:S55-64.
Christian, M. D., Joynt, G. M., Hick, J. L., Colvin, J., Danis, M., & Sprung, C. L. (2010). Chapter 7. Critical care triage. Recommendations and standard operating procedures for intensive care unit and hospital preparations for an influenza epidemic or mass disaster. Intensive Care Medicine, 36 Suppl 1, S55-64. https://doi.org/10.1007/s00134-010-1765-0
Christian MD, et al. Chapter 7. Critical Care Triage. Recommendations and Standard Operating Procedures for Intensive Care Unit and Hospital Preparations for an Influenza Epidemic or Mass Disaster. Intensive Care Med. 2010;36 Suppl 1:S55-64. PubMed PMID: 20213422.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Chapter 7. Critical care triage. Recommendations and standard operating procedures for intensive care unit and hospital preparations for an influenza epidemic or mass disaster. AU - Christian,Michael D, AU - Joynt,Gavin M, AU - Hick,John L, AU - Colvin,John, AU - Danis,Marion, AU - Sprung,Charles L, AU - ,, PY - 2010/3/10/entrez PY - 2010/3/23/pubmed PY - 2010/6/24/medline SP - S55 EP - 64 JF - Intensive care medicine JO - Intensive Care Med VL - 36 Suppl 1 N2 - PURPOSE: 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. METHODS: Based on a literature review and expert opinion, a Delphi process was used to define the essential topics including critical care triage. RESULTS: 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. CONCLUSIONS: Judicious planning and adoption of protocols for critical care triage are necessary to optimize outcomes during a pandemic. SN - 1432-1238 UR - https://www.unboundmedicine.com/medline/citation/20213422/Chapter_7__Critical_care_triage__Recommendations_and_standard_operating_procedures_for_intensive_care_unit_and_hospital_preparations_for_an_influenza_epidemic_or_mass_disaster_ L2 - https://dx.doi.org/10.1007/s00134-010-1765-0 DB - PRIME DP - Unbound Medicine ER -