Triage of Scarce Critical Care Resources in COVID-19 An Implementation Guide for Regional Allocation: An Expert Panel Report of the Task Force for Mass Critical Care and the American College of Chest Physicians.
Identifieur interne : 000242 ( Main/Corpus ); précédent : 000241; suivant : 000243Triage of Scarce Critical Care Resources in COVID-19 An Implementation Guide for Regional Allocation: An Expert Panel Report of the Task Force for Mass Critical Care and the American College of Chest Physicians.
Auteurs : Ryan C. Maves ; James Downar ; Jeffrey R. Dichter ; John L. Hick ; Asha Devereaux ; James A. Geiling ; Niranjan Kissoon ; Nathaniel Hupert ; Alexander S. Niven ; Mary A. King ; Lewis L. Rubinson ; Dan Hanfling ; James G. Hodge ; Mary Faith Marshall ; Katherine Fischkoff ; Laura E. Evans ; Mark R. Tonelli ; Randy S. Wax ; Gilbert Seda ; John S. Parrish ; Robert D. Truog ; Charles L. Sprung ; Michael D. ChristianSource :
- Chest [ 1931-3543 ] ; 2020.
English descriptors
- KwdEn :
- Betacoronavirus (isolation & purification), COVID-19 (MeSH), Coronavirus Infections (epidemiology), Coronavirus Infections (therapy), Critical Care (methods), Humans (MeSH), Pandemics (MeSH), Pneumonia, Viral (epidemiology), Pneumonia, Viral (therapy), Public Health (ethics), Public Health (methods), Public Health (standards), Resource Allocation (organization & administration), SARS-CoV-2 (MeSH), Surge Capacity (ethics), Surge Capacity (organization & administration), Triage (organization & administration).
- MESH :
- epidemiology : Coronavirus Infections, Pneumonia, Viral.
- ethics : Public Health, Surge Capacity.
- isolation & purification : Betacoronavirus.
- methods : Critical Care, Public Health.
- organization & administration : Resource Allocation, Surge Capacity, Triage.
- standards : Public Health.
- therapy : Coronavirus Infections, Pneumonia, Viral.
- COVID-19, Humans, Pandemics, SARS-CoV-2.
Abstract
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.
DOI: 10.1016/j.chest.2020.03.063
PubMed: 32289312
PubMed Central: PMC7151463
Links to Exploration step
pubmed:32289312Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Triage of Scarce Critical Care Resources in COVID-19 An Implementation Guide for Regional Allocation: An Expert Panel Report of the Task Force for Mass Critical Care and the American College of Chest Physicians.</title><author><name sortKey="Maves, Ryan C" sort="Maves, Ryan C" uniqKey="Maves R" first="Ryan C" last="Maves">Ryan C. Maves</name><affiliation><nlm:affiliation>Naval Medical Center, San Diego, CA.</nlm:affiliation></affiliation></author><author><name sortKey="Downar, James" sort="Downar, James" uniqKey="Downar J" first="James" last="Downar">James Downar</name><affiliation><nlm:affiliation>University of Ottawa, Ottawa, ON, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Dichter, Jeffrey R" sort="Dichter, Jeffrey R" uniqKey="Dichter J" first="Jeffrey R" last="Dichter">Jeffrey R. Dichter</name><affiliation><nlm:affiliation>University of Minnesota, Minneapolis, MN. Electronic address: jrdichter1@gmail.com.</nlm:affiliation></affiliation></author><author><name sortKey="Hick, John L" sort="Hick, John L" uniqKey="Hick J" first="John L" last="Hick">John L. Hick</name><affiliation><nlm:affiliation>Hennepin County Medical Center, Minneapolis, MN.</nlm:affiliation></affiliation></author><author><name sortKey="Devereaux, Asha" sort="Devereaux, Asha" uniqKey="Devereaux A" first="Asha" last="Devereaux">Asha Devereaux</name><affiliation><nlm:affiliation>Sharp Coronado Hospital, Coronado, CA.</nlm:affiliation></affiliation></author><author><name sortKey="Geiling, James A" sort="Geiling, James A" uniqKey="Geiling J" first="James A" last="Geiling">James A. Geiling</name><affiliation><nlm:affiliation>Geisel School of Medicine at Dartmouth College, Hanover, NH.</nlm:affiliation></affiliation></author><author><name sortKey="Kissoon, Niranjan" sort="Kissoon, Niranjan" uniqKey="Kissoon N" first="Niranjan" last="Kissoon">Niranjan Kissoon</name><affiliation><nlm:affiliation>University of British Columbia, Vancouver, BC, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Hupert, Nathaniel" sort="Hupert, Nathaniel" uniqKey="Hupert N" first="Nathaniel" last="Hupert">Nathaniel Hupert</name><affiliation><nlm:affiliation>Weill Cornell Medical College, New York, NY.</nlm:affiliation></affiliation></author><author><name sortKey="Niven, Alexander S" sort="Niven, Alexander S" uniqKey="Niven A" first="Alexander S" last="Niven">Alexander S. Niven</name><affiliation><nlm:affiliation>Mayo Clinic, Rochester, MN.</nlm:affiliation></affiliation></author><author><name sortKey="King, Mary A" sort="King, Mary A" uniqKey="King M" first="Mary A" last="King">Mary A. King</name><affiliation><nlm:affiliation>University of Washington, Seattle, WA.</nlm:affiliation></affiliation></author><author><name sortKey="Rubinson, Lewis L" sort="Rubinson, Lewis L" uniqKey="Rubinson L" first="Lewis L" last="Rubinson">Lewis L. Rubinson</name><affiliation><nlm:affiliation>Morristown Medical Center, Morristown, NJ.</nlm:affiliation></affiliation></author><author><name sortKey="Hanfling, Dan" sort="Hanfling, Dan" uniqKey="Hanfling D" first="Dan" last="Hanfling">Dan Hanfling</name><affiliation><nlm:affiliation>Inova Fairfax Hospital, Falls Church, VA.</nlm:affiliation></affiliation></author><author><name sortKey="Hodge, James G" sort="Hodge, James G" uniqKey="Hodge J" first="James G" last="Hodge">James G. Hodge</name><affiliation><nlm:affiliation>Arizona State University, Tempe, AZ.</nlm:affiliation></affiliation></author><author><name sortKey="Marshall, Mary Faith" sort="Marshall, Mary Faith" uniqKey="Marshall M" first="Mary Faith" last="Marshall">Mary Faith Marshall</name><affiliation><nlm:affiliation>University of Virginia, Charlottesville, VA.</nlm:affiliation></affiliation></author><author><name sortKey="Fischkoff, Katherine" sort="Fischkoff, Katherine" uniqKey="Fischkoff K" first="Katherine" last="Fischkoff">Katherine Fischkoff</name><affiliation><nlm:affiliation>Columbia University, New York, NY.</nlm:affiliation></affiliation></author><author><name sortKey="Evans, Laura E" sort="Evans, Laura E" uniqKey="Evans L" first="Laura E" last="Evans">Laura E. Evans</name><affiliation><nlm:affiliation>University of Washington, Seattle, WA.</nlm:affiliation></affiliation></author><author><name sortKey="Tonelli, Mark R" sort="Tonelli, Mark R" uniqKey="Tonelli M" first="Mark R" last="Tonelli">Mark R. Tonelli</name><affiliation><nlm:affiliation>University of Washington, Seattle, WA.</nlm:affiliation></affiliation></author><author><name sortKey="Wax, Randy S" sort="Wax, Randy S" uniqKey="Wax R" first="Randy S" last="Wax">Randy S. Wax</name><affiliation><nlm:affiliation>Queen's University, Kingston, ON, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Seda, Gilbert" sort="Seda, Gilbert" uniqKey="Seda G" first="Gilbert" last="Seda">Gilbert Seda</name><affiliation><nlm:affiliation>Naval Medical Center, San Diego, CA.</nlm:affiliation></affiliation></author><author><name sortKey="Parrish, John S" sort="Parrish, John S" uniqKey="Parrish J" first="John S" last="Parrish">John S. Parrish</name><affiliation><nlm:affiliation>Naval Medical Center, San Diego, CA.</nlm:affiliation></affiliation></author><author><name sortKey="Truog, Robert D" sort="Truog, Robert D" uniqKey="Truog R" first="Robert D" last="Truog">Robert D. Truog</name><affiliation><nlm:affiliation>Harvard Medical School, Boston, MA.</nlm:affiliation></affiliation></author><author><name sortKey="Sprung, Charles L" sort="Sprung, Charles L" uniqKey="Sprung C" first="Charles L" last="Sprung">Charles L. Sprung</name><affiliation><nlm:affiliation>Faculty of Medicine, Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel.</nlm:affiliation></affiliation></author><author><name sortKey="Christian, Michael D" sort="Christian, Michael D" uniqKey="Christian M" first="Michael D" last="Christian">Michael D. Christian</name><affiliation><nlm:affiliation>London's Air Ambulance, Royal London Hospital, Barts NHS Health Trust, London, England.</nlm:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2020">2020</date><idno type="RBID">pubmed:32289312</idno><idno type="pmid">32289312</idno><idno type="doi">10.1016/j.chest.2020.03.063</idno><idno type="pmc">PMC7151463</idno><idno type="wicri:Area/Main/Corpus">000242</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000242</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Triage of Scarce Critical Care Resources in COVID-19 An Implementation Guide for Regional Allocation: An Expert Panel Report of the Task Force for Mass Critical Care and the American College of Chest Physicians.</title><author><name sortKey="Maves, Ryan C" sort="Maves, Ryan C" uniqKey="Maves R" first="Ryan C" last="Maves">Ryan C. Maves</name><affiliation><nlm:affiliation>Naval Medical Center, San Diego, CA.</nlm:affiliation></affiliation></author><author><name sortKey="Downar, James" sort="Downar, James" uniqKey="Downar J" first="James" last="Downar">James Downar</name><affiliation><nlm:affiliation>University of Ottawa, Ottawa, ON, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Dichter, Jeffrey R" sort="Dichter, Jeffrey R" uniqKey="Dichter J" first="Jeffrey R" last="Dichter">Jeffrey R. Dichter</name><affiliation><nlm:affiliation>University of Minnesota, Minneapolis, MN. Electronic address: jrdichter1@gmail.com.</nlm:affiliation></affiliation></author><author><name sortKey="Hick, John L" sort="Hick, John L" uniqKey="Hick J" first="John L" last="Hick">John L. Hick</name><affiliation><nlm:affiliation>Hennepin County Medical Center, Minneapolis, MN.</nlm:affiliation></affiliation></author><author><name sortKey="Devereaux, Asha" sort="Devereaux, Asha" uniqKey="Devereaux A" first="Asha" last="Devereaux">Asha Devereaux</name><affiliation><nlm:affiliation>Sharp Coronado Hospital, Coronado, CA.</nlm:affiliation></affiliation></author><author><name sortKey="Geiling, James A" sort="Geiling, James A" uniqKey="Geiling J" first="James A" last="Geiling">James A. Geiling</name><affiliation><nlm:affiliation>Geisel School of Medicine at Dartmouth College, Hanover, NH.</nlm:affiliation></affiliation></author><author><name sortKey="Kissoon, Niranjan" sort="Kissoon, Niranjan" uniqKey="Kissoon N" first="Niranjan" last="Kissoon">Niranjan Kissoon</name><affiliation><nlm:affiliation>University of British Columbia, Vancouver, BC, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Hupert, Nathaniel" sort="Hupert, Nathaniel" uniqKey="Hupert N" first="Nathaniel" last="Hupert">Nathaniel Hupert</name><affiliation><nlm:affiliation>Weill Cornell Medical College, New York, NY.</nlm:affiliation></affiliation></author><author><name sortKey="Niven, Alexander S" sort="Niven, Alexander S" uniqKey="Niven A" first="Alexander S" last="Niven">Alexander S. Niven</name><affiliation><nlm:affiliation>Mayo Clinic, Rochester, MN.</nlm:affiliation></affiliation></author><author><name sortKey="King, Mary A" sort="King, Mary A" uniqKey="King M" first="Mary A" last="King">Mary A. King</name><affiliation><nlm:affiliation>University of Washington, Seattle, WA.</nlm:affiliation></affiliation></author><author><name sortKey="Rubinson, Lewis L" sort="Rubinson, Lewis L" uniqKey="Rubinson L" first="Lewis L" last="Rubinson">Lewis L. Rubinson</name><affiliation><nlm:affiliation>Morristown Medical Center, Morristown, NJ.</nlm:affiliation></affiliation></author><author><name sortKey="Hanfling, Dan" sort="Hanfling, Dan" uniqKey="Hanfling D" first="Dan" last="Hanfling">Dan Hanfling</name><affiliation><nlm:affiliation>Inova Fairfax Hospital, Falls Church, VA.</nlm:affiliation></affiliation></author><author><name sortKey="Hodge, James G" sort="Hodge, James G" uniqKey="Hodge J" first="James G" last="Hodge">James G. Hodge</name><affiliation><nlm:affiliation>Arizona State University, Tempe, AZ.</nlm:affiliation></affiliation></author><author><name sortKey="Marshall, Mary Faith" sort="Marshall, Mary Faith" uniqKey="Marshall M" first="Mary Faith" last="Marshall">Mary Faith Marshall</name><affiliation><nlm:affiliation>University of Virginia, Charlottesville, VA.</nlm:affiliation></affiliation></author><author><name sortKey="Fischkoff, Katherine" sort="Fischkoff, Katherine" uniqKey="Fischkoff K" first="Katherine" last="Fischkoff">Katherine Fischkoff</name><affiliation><nlm:affiliation>Columbia University, New York, NY.</nlm:affiliation></affiliation></author><author><name sortKey="Evans, Laura E" sort="Evans, Laura E" uniqKey="Evans L" first="Laura E" last="Evans">Laura E. Evans</name><affiliation><nlm:affiliation>University of Washington, Seattle, WA.</nlm:affiliation></affiliation></author><author><name sortKey="Tonelli, Mark R" sort="Tonelli, Mark R" uniqKey="Tonelli M" first="Mark R" last="Tonelli">Mark R. Tonelli</name><affiliation><nlm:affiliation>University of Washington, Seattle, WA.</nlm:affiliation></affiliation></author><author><name sortKey="Wax, Randy S" sort="Wax, Randy S" uniqKey="Wax R" first="Randy S" last="Wax">Randy S. Wax</name><affiliation><nlm:affiliation>Queen's University, Kingston, ON, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Seda, Gilbert" sort="Seda, Gilbert" uniqKey="Seda G" first="Gilbert" last="Seda">Gilbert Seda</name><affiliation><nlm:affiliation>Naval Medical Center, San Diego, CA.</nlm:affiliation></affiliation></author><author><name sortKey="Parrish, John S" sort="Parrish, John S" uniqKey="Parrish J" first="John S" last="Parrish">John S. Parrish</name><affiliation><nlm:affiliation>Naval Medical Center, San Diego, CA.</nlm:affiliation></affiliation></author><author><name sortKey="Truog, Robert D" sort="Truog, Robert D" uniqKey="Truog R" first="Robert D" last="Truog">Robert D. Truog</name><affiliation><nlm:affiliation>Harvard Medical School, Boston, MA.</nlm:affiliation></affiliation></author><author><name sortKey="Sprung, Charles L" sort="Sprung, Charles L" uniqKey="Sprung C" first="Charles L" last="Sprung">Charles L. Sprung</name><affiliation><nlm:affiliation>Faculty of Medicine, Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel.</nlm:affiliation></affiliation></author><author><name sortKey="Christian, Michael D" sort="Christian, Michael D" uniqKey="Christian M" first="Michael D" last="Christian">Michael D. Christian</name><affiliation><nlm:affiliation>London's Air Ambulance, Royal London Hospital, Barts NHS Health Trust, London, England.</nlm:affiliation></affiliation></author></analytic><series><title level="j">Chest</title><idno type="eISSN">1931-3543</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Betacoronavirus (isolation & purification)</term><term>COVID-19 (MeSH)</term><term>Coronavirus Infections (epidemiology)</term><term>Coronavirus Infections (therapy)</term><term>Critical Care (methods)</term><term>Humans (MeSH)</term><term>Pandemics (MeSH)</term><term>Pneumonia, Viral (epidemiology)</term><term>Pneumonia, Viral (therapy)</term><term>Public Health (ethics)</term><term>Public Health (methods)</term><term>Public Health (standards)</term><term>Resource Allocation (organization & administration)</term><term>SARS-CoV-2 (MeSH)</term><term>Surge Capacity (ethics)</term><term>Surge Capacity (organization & administration)</term><term>Triage (organization & administration)</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Coronavirus Infections</term><term>Pneumonia, Viral</term></keywords><keywords scheme="MESH" qualifier="ethics" xml:lang="en"><term>Public Health</term><term>Surge Capacity</term></keywords><keywords scheme="MESH" qualifier="isolation & purification" xml:lang="en"><term>Betacoronavirus</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Critical Care</term><term>Public Health</term></keywords><keywords scheme="MESH" qualifier="organization & administration" xml:lang="en"><term>Resource Allocation</term><term>Surge Capacity</term><term>Triage</term></keywords><keywords scheme="MESH" qualifier="standards" xml:lang="en"><term>Public Health</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Coronavirus Infections</term><term>Pneumonia, Viral</term></keywords><keywords scheme="MESH" xml:lang="en"><term>COVID-19</term><term>Humans</term><term>Pandemics</term><term>SARS-CoV-2</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">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.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">32289312</PMID><DateCompleted><Year>2020</Year><Month>07</Month><Day>20</Day></DateCompleted><DateRevised><Year>2020</Year><Month>12</Month><Day>10</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1931-3543</ISSN><JournalIssue CitedMedium="Internet"><Volume>158</Volume><Issue>1</Issue><PubDate><Year>2020</Year><Month>07</Month></PubDate></JournalIssue><Title>Chest</Title><ISOAbbreviation>Chest</ISOAbbreviation></Journal><ArticleTitle>Triage of Scarce Critical Care Resources in COVID-19 An Implementation Guide for Regional Allocation: An Expert Panel Report of the Task Force for Mass Critical Care and the American College of Chest Physicians.</ArticleTitle><Pagination><MedlinePgn>212-225</MedlinePgn></Pagination><ELocationID EIdType="pii" ValidYN="Y">S0012-3692(20)30691-7</ELocationID><ELocationID EIdType="doi" ValidYN="Y">10.1016/j.chest.2020.03.063</ELocationID><Abstract><AbstractText>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.</AbstractText><CopyrightInformation>Copyright © 2020. Published by Elsevier Inc.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Maves</LastName><ForeName>Ryan C</ForeName><Initials>RC</Initials><AffiliationInfo><Affiliation>Naval Medical Center, San Diego, CA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Downar</LastName><ForeName>James</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>University of Ottawa, Ottawa, ON, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Dichter</LastName><ForeName>Jeffrey R</ForeName><Initials>JR</Initials><AffiliationInfo><Affiliation>University of Minnesota, Minneapolis, MN. Electronic address: jrdichter1@gmail.com.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Hick</LastName><ForeName>John L</ForeName><Initials>JL</Initials><AffiliationInfo><Affiliation>Hennepin County Medical Center, Minneapolis, MN.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Devereaux</LastName><ForeName>Asha</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Sharp Coronado Hospital, Coronado, CA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Geiling</LastName><ForeName>James A</ForeName><Initials>JA</Initials><AffiliationInfo><Affiliation>Geisel School of Medicine at Dartmouth College, Hanover, NH.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kissoon</LastName><ForeName>Niranjan</ForeName><Initials>N</Initials><AffiliationInfo><Affiliation>University of British Columbia, Vancouver, BC, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Hupert</LastName><ForeName>Nathaniel</ForeName><Initials>N</Initials><AffiliationInfo><Affiliation>Weill Cornell Medical College, New York, NY.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Niven</LastName><ForeName>Alexander S</ForeName><Initials>AS</Initials><AffiliationInfo><Affiliation>Mayo Clinic, Rochester, MN.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>King</LastName><ForeName>Mary A</ForeName><Initials>MA</Initials><AffiliationInfo><Affiliation>University of Washington, Seattle, WA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Rubinson</LastName><ForeName>Lewis L</ForeName><Initials>LL</Initials><AffiliationInfo><Affiliation>Morristown Medical Center, Morristown, NJ.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Hanfling</LastName><ForeName>Dan</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>Inova Fairfax Hospital, Falls Church, VA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Hodge</LastName><ForeName>James G</ForeName><Initials>JG</Initials><Suffix>Jr</Suffix><AffiliationInfo><Affiliation>Arizona State University, Tempe, AZ.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Marshall</LastName><ForeName>Mary Faith</ForeName><Initials>MF</Initials><AffiliationInfo><Affiliation>University of Virginia, Charlottesville, VA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Fischkoff</LastName><ForeName>Katherine</ForeName><Initials>K</Initials><AffiliationInfo><Affiliation>Columbia University, New York, NY.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Evans</LastName><ForeName>Laura E</ForeName><Initials>LE</Initials><AffiliationInfo><Affiliation>University of Washington, Seattle, WA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Tonelli</LastName><ForeName>Mark R</ForeName><Initials>MR</Initials><AffiliationInfo><Affiliation>University of Washington, Seattle, WA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Wax</LastName><ForeName>Randy S</ForeName><Initials>RS</Initials><AffiliationInfo><Affiliation>Queen's University, Kingston, ON, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Seda</LastName><ForeName>Gilbert</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>Naval Medical Center, San Diego, CA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Parrish</LastName><ForeName>John S</ForeName><Initials>JS</Initials><AffiliationInfo><Affiliation>Naval Medical Center, San Diego, CA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Truog</LastName><ForeName>Robert D</ForeName><Initials>RD</Initials><AffiliationInfo><Affiliation>Harvard Medical School, Boston, MA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Sprung</LastName><ForeName>Charles L</ForeName><Initials>CL</Initials><AffiliationInfo><Affiliation>Faculty of Medicine, Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Christian</LastName><ForeName>Michael D</ForeName><Initials>MD</Initials><AffiliationInfo><Affiliation>London's Air Ambulance, Royal London Hospital, Barts NHS Health Trust, London, England.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><CollectiveName>ACCP Task Force for Mass Critical Care</CollectiveName></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D016454">Review</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>04</Month><Day>11</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Chest</MedlineTA><NlmUniqueID>0231335</NlmUniqueID><ISSNLinking>0012-3692</ISSNLinking></MedlineJournalInfo><SupplMeshList><SupplMeshName Type="Disease" UI="C000657245">COVID-19</SupplMeshName><SupplMeshName Type="Organism" UI="C000656484">severe acute respiratory syndrome coronavirus 2</SupplMeshName></SupplMeshList><CitationSubset>AIM</CitationSubset><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000073640" MajorTopicYN="N">Betacoronavirus</DescriptorName><QualifierName UI="Q000302" MajorTopicYN="N">isolation & purification</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D000086382" MajorTopicYN="N">COVID-19</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D018352" MajorTopicYN="Y">Coronavirus Infections</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName><QualifierName UI="Q000628" MajorTopicYN="N">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D003422" MajorTopicYN="N">Critical Care</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="N">methods</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D058873" MajorTopicYN="Y">Pandemics</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011024" MajorTopicYN="Y">Pneumonia, Viral</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName><QualifierName UI="Q000628" MajorTopicYN="N">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D011634" MajorTopicYN="N">Public Health</DescriptorName><QualifierName UI="Q000941" MajorTopicYN="N">ethics</QualifierName><QualifierName UI="Q000379" MajorTopicYN="N">methods</QualifierName><QualifierName UI="Q000592" MajorTopicYN="N">standards</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D040841" MajorTopicYN="N">Resource Allocation</DescriptorName><QualifierName UI="Q000458" MajorTopicYN="Y">organization & administration</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D000086402" MajorTopicYN="N">SARS-CoV-2</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D055872" MajorTopicYN="N">Surge Capacity</DescriptorName><QualifierName UI="Q000941" MajorTopicYN="N">ethics</QualifierName><QualifierName UI="Q000458" MajorTopicYN="N">organization & administration</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D014218" MajorTopicYN="N">Triage</DescriptorName><QualifierName UI="Q000458" MajorTopicYN="Y">organization & administration</QualifierName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="Y">COVID-19 pandemic</Keyword><Keyword MajorTopicYN="Y">disaster preparedness</Keyword><Keyword MajorTopicYN="Y">scarcity of resources</Keyword><Keyword MajorTopicYN="Y">surge capacity</Keyword><Keyword MajorTopicYN="Y">triage</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2020</Year><Month>03</Month><Day>27</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2020</Year><Month>03</Month><Day>31</Day></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2020</Year><Month>4</Month><Day>15</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2020</Year><Month>7</Month><Day>21</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2020</Year><Month>4</Month><Day>15</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">32289312</ArticleId><ArticleId IdType="pii">S0012-3692(20)30691-7</ArticleId><ArticleId IdType="doi">10.1016/j.chest.2020.03.063</ArticleId><ArticleId 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