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Special Populations: Care of the Critically Ill and Injured During Pandemics and Disasters: CHEST Consensus Statement.
Chest. 2014 Aug 21;
Authors: Dries DJ, Reed MJ, Kissoon N, Christian MD, Dichter JR, Devereaux A, Upperman JS
Abstract
Abstract: BackgroundPast disasters have highlighted the need to prepare for subsets of those critically ill medically fragile patients. These chronic, medically fragile patients require focused disaster planning that will address their medical needs throughout the event in order to prevent clinical deterioration. The suggestions in this chapter are important for all who are involved in large-scale disasters or pandemics with multiple critically ill or injured patients including front line clinicians, hospital administrators and public health or government officials. Methodology:Key questions regarding the care of critically ill or injured special populations during disaster or pandemic were identified and subsequently a systematic literature (1985-2013) review was performed. No studies of sufficient quality were identified. Therefore, the panel developed expert opinion-based suggestions utilizing a modified Delphi process. The panel did not include pediatrics as a separate special population since pediatrics issues are embedded in each consensus document. Results:Fourteen suggestions were formulated regarding the care of the critically ill and injured from special populations during disasters and pandemics. The suggestions cover the following areas: Defining Special Populations for Mass Critical Care, Special Population Planning, Planning for Access to Regionalized Service for Special Populations, Triage and Resource Allocation of Special Populations, Therapeutic Considerations, and Crisis Standards of Care for Special Populations. Conclusions:The chronically ill, technologically dependent and complex critically ill patients present a unique challenge to preparing and implementing mass critical care. There are, however, unique opportunities to engage patients, primary physicians, advocacy groups, and professional organizations to lessen the impact of disaster on these special populations.
Background: Past disasters have highlighted the need to prepare for subsets of those critically ill medically fragile patients. These chronic, medically fragile patients require focused disaster planning that will address their medical needs throughout the event in order to prevent clinical deterioration. The suggestions in this chapter are important for all who are involved in large-scale disasters or pandemics with multiple critically ill or injured patients including front line clinicians, hospital administrators and public health or government officials.
Methodology: Key questions regarding the care of critically ill or injured special populations during disaster or pandemic were identified and subsequently a systematic literature (1985-2013) review was performed. No studies of sufficient quality were identified. Therefore, the panel developed expert opinion-based suggestions utilizing a modified Delphi process. The panel did not include pediatrics as a separate special population since pediatrics issues are embedded in each consensus document.
Results: Fourteen suggestions were formulated regarding the care of the critically ill and injured from special populations during disasters and pandemics. The suggestions cover the following areas: Defining Special Populations for Mass Critical Care, Special Population Planning, Planning for Access to Regionalized Service for Special Populations, Triage and Resource Allocation of Special Populations, Therapeutic Considerations, and Crisis Standards of Care for Special Populations.
Conclusions: The chronically ill, technologically dependent and complex critically ill patients present a unique challenge to preparing and implementing mass critical care. There are, however, unique opportunities to engage patients, primary physicians, advocacy groups, and professional organizations to lessen the impact of disaster on these special populations.
PMID: 25144661 [PubMed - as supplied by publisher]