Too Many Patients…A Framework to Guide Statewide Allocation of Scarce Mechanical Ventilation During Disasters
Autor: | Howard S. Gwon, Alan Regenberg, Ruth R. Faden, Jack Schwartz, Darren P. Mareiniss, E. Lee Daugherty Biddison, Monica Schoch-Spana, Eric Toner |
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Rok vydání: | 2019 |
Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty Critical Care Process (engineering) Critical Illness Decision Making Critical Care and Intensive Care Medicine Resource Allocation Disasters 03 medical and health sciences 0302 clinical medicine Humans Medicine 030212 general & internal medicine Community engagement business.industry Public health Liability Respiration Artificial Triage 030228 respiratory system Risk analysis (engineering) Preparedness Scale (social sciences) Resource allocation Public Health Cardiology and Cardiovascular Medicine business |
Zdroj: | Chest. 155:848-854 |
ISSN: | 0012-3692 |
Popis: | The threat of a catastrophic public health emergency causing life-threatening illness or injury on a massive scale has prompted extensive federal, state, and local preparedness efforts. Modeling studies suggest that an influenza pandemic similar to that of 1918 would require ICU and mechanical ventilation capacity that is significantly greater than what is available. Several groups have published recommendations for allocating life-support measures during a public health emergency. Because there are multiple ethically permissible approaches to allocating scarce life-sustaining resources and because the public will bear the consequences of these decisions, knowledge of public perspectives and moral points of reference on these issues is critical. Here we describe a critical care disaster resource allocation framework developed following a statewide community engagement process in Maryland. It is intended to assist hospitals and public health agencies in their independent and coordinated response to an officially declared catastrophic health emergency in which demand for mechanical ventilators exceeds the capabilities of all surge response efforts and in which there has been an executive order to implement scarce resource allocation procedures. The framework, built on a basic scoring system with modifications for specific considerations, also creates an opportunity for the legal community to review existing laws and liability protections in light of a specific disaster response process. |
Databáze: | OpenAIRE |
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