Too Many Patients…A Framework to Guide Statewide Allocation of Scarce Mechanical Ventilation During Disasters.
Identifieur interne : 000075 ( PubMed/Checkpoint ); précédent : 000074; suivant : 000076Too Many Patients…A Framework to Guide Statewide Allocation of Scarce Mechanical Ventilation During Disasters.
Auteurs : E Lee Daugherty Biddison [États-Unis] ; Ruth Faden [États-Unis] ; Howard S. Gwon [États-Unis] ; Darren P. Mareiniss [États-Unis] ; Alan C. Regenberg [États-Unis] ; Monica Schoch-Spana [États-Unis] ; Jack Schwartz [États-Unis] ; Eric S. Toner [États-Unis]Source :
- Chest [ 1931-3543 ] ; 2019.
Descripteurs français
- KwdFr :
- MESH :
English descriptors
- KwdEn :
- MESH :
- methods : Critical Care, Resource Allocation, Respiration, Artificial, Triage.
- therapy : Critical Illness.
- Decision Making, Disasters, Humans, Public Health.
Abstract
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.
DOI: 10.1016/j.chest.2018.09.025
PubMed: 30316913
Affiliations:
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Gwon</name><affiliation wicri:level="2"><nlm:affiliation>Johns Hopkins Medicine, Baltimore, MD.</nlm:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Maryland</region></placeName><wicri:cityArea>Johns Hopkins Medicine, Baltimore</wicri:cityArea></affiliation></author><author><name sortKey="Mareiniss, Darren P" sort="Mareiniss, Darren P" uniqKey="Mareiniss D" first="Darren P" last="Mareiniss">Darren P. Mareiniss</name><affiliation wicri:level="2"><nlm:affiliation>Georgetown University School of Medicine, Washington, DC.</nlm:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">District de Columbia</region></placeName><wicri:cityArea>Georgetown University School of Medicine, Washington</wicri:cityArea></affiliation></author><author><name sortKey="Regenberg, Alan C" sort="Regenberg, Alan C" uniqKey="Regenberg A" first="Alan C" last="Regenberg">Alan C. 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Toner</name><affiliation wicri:level="2"><nlm:affiliation>Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.</nlm:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Maryland</region></placeName><wicri:cityArea>Johns Hopkins Bloomberg School of Public Health, Baltimore</wicri:cityArea></affiliation></author></analytic><series><title level="j">Chest</title><idno type="eISSN">1931-3543</idno><imprint><date when="2019" type="published">2019</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Critical Care (methods)</term><term>Critical Illness (therapy)</term><term>Decision Making</term><term>Disasters</term><term>Humans</term><term>Public Health</term><term>Resource Allocation (methods)</term><term>Respiration, Artificial (methods)</term><term>Triage (methods)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Allocation des ressources ()</term><term>Catastrophes</term><term>Humains</term><term>Maladie grave ()</term><term>Prise de décision</term><term>Santé publique</term><term>Soins de réanimation ()</term><term>Triage ()</term><term>Ventilation artificielle ()</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Critical Care</term><term>Resource Allocation</term><term>Respiration, Artificial</term><term>Triage</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Critical Illness</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Decision Making</term><term>Disasters</term><term>Humans</term><term>Public Health</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Allocation des ressources</term><term>Catastrophes</term><term>Humains</term><term>Maladie grave</term><term>Prise de décision</term><term>Santé publique</term><term>Soins de réanimation</term><term>Triage</term><term>Ventilation artificielle</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">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.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">30316913</PMID><DateCompleted><Year>2020</Year><Month>01</Month><Day>16</Day></DateCompleted><DateRevised><Year>2020</Year><Month>01</Month><Day>16</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1931-3543</ISSN><JournalIssue CitedMedium="Internet"><Volume>155</Volume><Issue>4</Issue><PubDate><Year>2019</Year><Month>04</Month></PubDate></JournalIssue><Title>Chest</Title><ISOAbbreviation>Chest</ISOAbbreviation></Journal><ArticleTitle>Too Many Patients…A Framework to Guide Statewide Allocation of Scarce Mechanical Ventilation During Disasters.</ArticleTitle><Pagination><MedlinePgn>848-854</MedlinePgn></Pagination><ELocationID EIdType="pii" ValidYN="Y">S0012-3692(18)32565-0</ELocationID><ELocationID EIdType="doi" ValidYN="Y">10.1016/j.chest.2018.09.025</ELocationID><Abstract><AbstractText>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.</AbstractText><CopyrightInformation>Copyright © 2018. Published by Elsevier Inc.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Daugherty Biddison</LastName><ForeName>E Lee</ForeName><Initials>EL</Initials><AffiliationInfo><Affiliation>Johns Hopkins University School of Medicine, Baltimore, MD. Electronic address: Lee.biddison@jhmi.edu.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Faden</LastName><ForeName>Ruth</ForeName><Initials>R</Initials><AffiliationInfo><Affiliation>Johns Hopkins Berman Institute of Bioethics, Baltimore, MD.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Gwon</LastName><ForeName>Howard S</ForeName><Initials>HS</Initials><AffiliationInfo><Affiliation>Johns Hopkins Medicine, Baltimore, MD.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Mareiniss</LastName><ForeName>Darren P</ForeName><Initials>DP</Initials><AffiliationInfo><Affiliation>Georgetown University School of Medicine, Washington, DC.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Regenberg</LastName><ForeName>Alan C</ForeName><Initials>AC</Initials><AffiliationInfo><Affiliation>Johns Hopkins Berman Institute of Bioethics, Baltimore, MD.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Schoch-Spana</LastName><ForeName>Monica</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Schwartz</LastName><ForeName>Jack</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>University of Maryland Carey School of Law, Baltimore, MD.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Toner</LastName><ForeName>Eric S</ForeName><Initials>ES</Initials><AffiliationInfo><Affiliation>Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D013486">Research Support, U.S. Gov't, Non-P.H.S.</PublicationType><PublicationType UI="D016454">Review</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2018</Year><Month>10</Month><Day>11</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Chest</MedlineTA><NlmUniqueID>0231335</NlmUniqueID><ISSNLinking>0012-3692</ISSNLinking></MedlineJournalInfo><CitationSubset>AIM</CitationSubset><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D003422" MajorTopicYN="N">Critical Care</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="Y">methods</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D016638" MajorTopicYN="N">Critical Illness</DescriptorName><QualifierName UI="Q000628" MajorTopicYN="Y">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D003657" MajorTopicYN="Y">Decision Making</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D004190" MajorTopicYN="Y">Disasters</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011634" MajorTopicYN="N">Public Health</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D040841" MajorTopicYN="N">Resource Allocation</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="Y">methods</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D012121" MajorTopicYN="N">Respiration, Artificial</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="Y">methods</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D014218" MajorTopicYN="N">Triage</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="Y">methods</QualifierName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="Y">disaster</Keyword><Keyword MajorTopicYN="Y">triage</Keyword><Keyword MajorTopicYN="Y">ventilator</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2018</Year><Month>06</Month><Day>15</Day></PubMedPubDate><PubMedPubDate PubStatus="revised"><Year>2018</Year><Month>09</Month><Day>04</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2018</Year><Month>09</Month><Day>24</Day></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2018</Year><Month>10</Month><Day>15</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2020</Year><Month>1</Month><Day>17</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2018</Year><Month>10</Month><Day>15</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">30316913</ArticleId><ArticleId IdType="pii">S0012-3692(18)32565-0</ArticleId><ArticleId IdType="doi">10.1016/j.chest.2018.09.025</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>États-Unis</li></country><region><li>District de Columbia</li><li>Maryland</li></region></list><tree><country name="États-Unis"><region name="Maryland"><name sortKey="Daugherty Biddison, E Lee" sort="Daugherty Biddison, E Lee" uniqKey="Daugherty Biddison E" first="E Lee" last="Daugherty Biddison">E Lee Daugherty Biddison</name></region><name sortKey="Faden, Ruth" sort="Faden, Ruth" uniqKey="Faden R" first="Ruth" last="Faden">Ruth Faden</name><name sortKey="Gwon, Howard S" sort="Gwon, Howard S" uniqKey="Gwon H" first="Howard S" last="Gwon">Howard S. Gwon</name><name sortKey="Mareiniss, Darren P" sort="Mareiniss, Darren P" uniqKey="Mareiniss D" first="Darren P" last="Mareiniss">Darren P. Mareiniss</name><name sortKey="Regenberg, Alan C" sort="Regenberg, Alan C" uniqKey="Regenberg A" first="Alan C" last="Regenberg">Alan C. Regenberg</name><name sortKey="Schoch Spana, Monica" sort="Schoch Spana, Monica" uniqKey="Schoch Spana M" first="Monica" last="Schoch-Spana">Monica Schoch-Spana</name><name sortKey="Schwartz, Jack" sort="Schwartz, Jack" uniqKey="Schwartz J" first="Jack" last="Schwartz">Jack Schwartz</name><name sortKey="Toner, Eric S" sort="Toner, Eric S" uniqKey="Toner E" first="Eric S" last="Toner">Eric S. Toner</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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