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Triage of Scarce Critical Care Resources in COVID-19 An Implementation Guide for Regional Allocation
Copyright policy Triage of Scarce Critical Care Resources in COVID-19 An Implementation Guide for Regional Allocation
Public health emergencies have the potential to place enormous strain on health systems. The current pandemic of the novel 2019 coronavirus disease has required hospitals in numerous countries to expand their surge capacity to meet the needs of patients with critical illness. When even surge capacity is exceeded, however, principles of critical care triage may be needed as a means to allocate scarce resources, such as mechanical ventilators or key medications. The goal of a triage system is to direct limited resources towards patients most likely to benefit from them. Implementing a triage system requires careful coordination between clinicians, health systems, local and regional governments, and the public, with a goal of transparency to maintain trust. We discuss the principles of tertiary triage and methods for implementing such a system, emphasizing that these systems should serve only as a last resort. Even under triage, we must uphold our obligation to care for all patients as best possible under difficult circumstances.
- Harvard University United States
- Hebrew University of Jerusalem Israel
- Naval Medical Center San Diego United States
- Cornell University United States
- University of Minnesota System United States
Microsoft Academic Graph classification: Medical emergency medicine.disease medicine Transparency (graphic) Triage business.industry business Pandemic Surge Capacity Scarcity media_common.quotation_subject media_common Public health medicine.medical_specialty Personal protective equipment Obligation
Cardiology and Cardiovascular Medicine, Critical Care and Intensive Care Medicine, Pulmonary and Respiratory Medicine
Cardiology and Cardiovascular Medicine, Critical Care and Intensive Care Medicine, Pulmonary and Respiratory Medicine
Microsoft Academic Graph classification: Medical emergency medicine.disease medicine Transparency (graphic) Triage business.industry business Pandemic Surge Capacity Scarcity media_common.quotation_subject media_common Public health medicine.medical_specialty Personal protective equipment Obligation
citations This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).192 popularity This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.Substantial influence This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).Substantial impulse This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.Substantial citations This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).192 popularity This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.Substantial influence This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).Substantial impulse This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.Substantial
Citations provided by BIP!Popularity provided by BIP!
- Harvard University United States
- Hebrew University of Jerusalem Israel
- Naval Medical Center San Diego United States
- Cornell University United States
- University of Minnesota System United States
- Mayo Clinic United States
- Mayo Clinic United States
- University of Virginia United States
- Inova Fairfax Hospital United States
- Morristown Medical Center United States
- University of British Columbia Canada
- University of Minnesota United States
- University of Ottawa Canada
- Atlantic Health System United States
- University of Mary United States
- Arizona State University United States
- Dartmouth College United States
- Hennepin County Medical Center United States
- Inova Health System United States
- King’s University United States
- Queen's University Canada
Public health emergencies have the potential to place enormous strain on health systems. The current pandemic of the novel 2019 coronavirus disease has required hospitals in numerous countries to expand their surge capacity to meet the needs of patients with critical illness. When even surge capacity is exceeded, however, principles of critical care triage may be needed as a means to allocate scarce resources, such as mechanical ventilators or key medications. The goal of a triage system is to direct limited resources towards patients most likely to benefit from them. Implementing a triage system requires careful coordination between clinicians, health systems, local and regional governments, and the public, with a goal of transparency to maintain trust. We discuss the principles of tertiary triage and methods for implementing such a system, emphasizing that these systems should serve only as a last resort. Even under triage, we must uphold our obligation to care for all patients as best possible under difficult circumstances.