Abstract
Background: In a public health emergency, many more patients could require mechanical ventilator than can be accommodated. Methods: To plan for such a crisis, the New York State Department of Health and the New York State Task Force on Life and the Law convened a workgroup to develop ethical and clinical guidelines for ventilator triage. Results: The workgroup crafted an ethical framework including the following components: duty to care, duty to steward resources, duty to plan, distributive justice, and transparency. Incorporating the ethical framework, the clinical guidelines propose both withholding and withdrawing ventilators from patients with the highest probability of mortality to benefit patients with the highest likelihood of survival. Triage scores derive from the sepsis-related organ failure assessment system, which assigns points based on function in 6 basic medical domains. Triage may not be implemented by a facility without clear permission from public health authorities. Conclusions: New York State released the draft guidelines for public comment, allowing for revision to reflect both community values and medical innovation. This ventilator triage system represents a radical shift from ordinary standards of care, and may serve as a model for allocating other scarce resources in disasters. (Disaster Med Public Health Preparedness. 2008;2:20-26)
| Original language | English (US) |
|---|---|
| Pages (from-to) | 20-26 |
| Number of pages | 7 |
| Journal | Disaster Medicine and Public Health Preparedness |
| Volume | 2 |
| Issue number | 1 |
| DOIs | |
| State | Published - Mar 2008 |
| Externally published | Yes |
Fingerprint
Keywords
- Guideline
- Influenza
- Pandemic
- Triage
- Ventilator
ASJC Scopus subject areas
- Public Health, Environmental and Occupational Health
Cite this
Allocation of ventilators in a public health disaster. / Powell, Patricia (Tia); Christ, Kelly C.; Birkhead, Guthrie S.
In: Disaster Medicine and Public Health Preparedness, Vol. 2, No. 1, 03.2008, p. 20-26.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Allocation of ventilators in a public health disaster
AU - Powell, Patricia (Tia)
AU - Christ, Kelly C.
AU - Birkhead, Guthrie S.
PY - 2008/3
Y1 - 2008/3
N2 - Background: In a public health emergency, many more patients could require mechanical ventilator than can be accommodated. Methods: To plan for such a crisis, the New York State Department of Health and the New York State Task Force on Life and the Law convened a workgroup to develop ethical and clinical guidelines for ventilator triage. Results: The workgroup crafted an ethical framework including the following components: duty to care, duty to steward resources, duty to plan, distributive justice, and transparency. Incorporating the ethical framework, the clinical guidelines propose both withholding and withdrawing ventilators from patients with the highest probability of mortality to benefit patients with the highest likelihood of survival. Triage scores derive from the sepsis-related organ failure assessment system, which assigns points based on function in 6 basic medical domains. Triage may not be implemented by a facility without clear permission from public health authorities. Conclusions: New York State released the draft guidelines for public comment, allowing for revision to reflect both community values and medical innovation. This ventilator triage system represents a radical shift from ordinary standards of care, and may serve as a model for allocating other scarce resources in disasters. (Disaster Med Public Health Preparedness. 2008;2:20-26)
AB - Background: In a public health emergency, many more patients could require mechanical ventilator than can be accommodated. Methods: To plan for such a crisis, the New York State Department of Health and the New York State Task Force on Life and the Law convened a workgroup to develop ethical and clinical guidelines for ventilator triage. Results: The workgroup crafted an ethical framework including the following components: duty to care, duty to steward resources, duty to plan, distributive justice, and transparency. Incorporating the ethical framework, the clinical guidelines propose both withholding and withdrawing ventilators from patients with the highest probability of mortality to benefit patients with the highest likelihood of survival. Triage scores derive from the sepsis-related organ failure assessment system, which assigns points based on function in 6 basic medical domains. Triage may not be implemented by a facility without clear permission from public health authorities. Conclusions: New York State released the draft guidelines for public comment, allowing for revision to reflect both community values and medical innovation. This ventilator triage system represents a radical shift from ordinary standards of care, and may serve as a model for allocating other scarce resources in disasters. (Disaster Med Public Health Preparedness. 2008;2:20-26)
KW - Guideline
KW - Influenza
KW - Pandemic
KW - Triage
KW - Ventilator
UR - http://www.scopus.com/inward/record.url?scp=42949113598&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=42949113598&partnerID=8YFLogxK
U2 - 10.1097/DMP.0b013e3181620794
DO - 10.1097/DMP.0b013e3181620794
M3 - Article
C2 - 18388654
AN - SCOPUS:42949113598
VL - 2
SP - 20
EP - 26
JO - Disaster Medicine and Public Health Preparedness
JF - Disaster Medicine and Public Health Preparedness
SN - 1935-7893
IS - 1
ER -