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
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
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DOI：
10.1016/j.chest.2020.03.063
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发表时间：
2020-07-01
期刊：
影响因子：
9.6
通讯作者：
Christian, Michael D.
中科院分区：
文献类型：
--
作者：
Maves, Ryan C.;Downar, James;Christian, Michael D.
突发公共卫生事件有可能给卫生系统带来巨大压力。目前2019新型冠状病毒病的大流行要求许多国家的医院扩大其激增能力，以满足危重患者的需求。然而，即使超出了激增能力，也可能需要重症监护分诊原则作为分配稀缺资源（例如机械呼吸机或关键药物）的手段。分流系统的目标是将有限的资源用于最有可能从中受益的患者。实施分诊系统需要临床医生、卫生系统、地方和地区政府以及公众之间的密切协调，目标是保持透明度以保持信任。我们讨论了三级分诊的原则和实施这样一个系统的方法，强调这些系统应该只作为最后的手段。即使在分流下，我们也必须履行我们的义务，在困难的情况下尽可能照顾所有病人。
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.