Worst case: rethinking tertiary triage protocols in pandemics and other health emergencies

Demand for critical care resources could vastly outstrip supply in an influenza pandemic or other health emergency, which has led expert groups to propose altered standards for triage and resource allocation. A pilot study by Christian and colleagues applied the Ontario, Canada draft critical care t...

Full description

Saved in:
Bibliographic Details
Published in:Critical care (London, England) England), 2010-01, Vol.14 (1), p.103-103
Main Author: Fink, Sheri L
Format: Article
Language:English
Subjects:
Disease Outbreaks
Female
Humans
Influenza A Virus, H1N1 Subtype
Influenza, Human - epidemiology
Male
Triage - methods
Citations: Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Demand for critical care resources could vastly outstrip supply in an influenza pandemic or other health emergency, which has led expert groups to propose altered standards for triage and resource allocation. A pilot study by Christian and colleagues applied the Ontario, Canada draft critical care triage protocol to an actual retrospective cohort of intensive care unit patients. The findings are troubling. Patients who would have been triaged to expectant and designated for withdrawal of intensive care unit care and ventilator support in fact had substantial survival rates. Triage officers often disagreed and lacked confidence in their categorization decisions. These findings suggest that rationing paradigms which include categorical exclusion criteria and withdrawal of lifesaving resources should be reconsidered, and public input sought on nonclinical aspects.
ISSN:1364-8535
1466-609X
DOI:10.1186/cc8216