Introduction and executive summary: care of the critically ill and injured during pandemics and disasters: CHEST consensus statement.
Introduction and executive summary: care of the critically ill and injured during pandemics and disasters: CHEST consensus statement.
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DOI：
10.1378/chest.14-0732
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发表时间：
2014-10-01
期刊：
影响因子：
9.6
通讯作者：
Kissoon, Niranjan
中科院分区：
文献类型：
--
作者：
Christian, Michael D;Devereaux, Asha V;Kissoon, Niranjan
自然灾害、工业事故、恐怖主义袭击和流行病都有可能导致大量危重病人或受伤病人。本附录为所有参与灾难或大流行、有多名危重患者的人提供建议，包括一线临床医生、医院管理人员、专业协会以及公共卫生或政府官员。目前的工作队共有来自9个国家的100名参与者，由来自不同学科的临床医生和专家组成。进行了全面的文献搜索，以确定可以根据证据提出建议的研究。没有确定有足够质量的研究。因此，专家小组制定了基于专家意见的建议，这些建议在本补编中使用了改进的德尔菲法。该补编的最终目的是将重点扩大到ICU之外，为所有因大流行或灾难而导致的危重或受伤的成年人和儿童的管理提供建议，无论在哪里提供这种护理。对危重病人的管理考虑包括临床优先事项和后勤(供应、疏散和分诊)，以及促进提供这种护理的关键因素(系统规划、业务连续性、法律框架和伦理考虑)。本补编还旨在说明如何将大规模危重护理的概念整合到从常规护理到应急护理再到危机护理标准的各种突发事件。
Natural disasters, industrial accidents, terrorism attacks, and pandemics all have the capacity to result in large numbers of critically ill or injured patients. This supplement provides suggestions for all of those involved in a disaster or pandemic with multiple critically ill patients, including front-line clinicians, hospital administrators, professional societies, and public health or government officials. The current Task Force included a total of 100 participants from nine countries, comprised of clinicians and experts from a wide variety of disciplines. Comprehensive literature searches were conducted to identify studies upon which evidence-based recommendations could be made. No studies of sufficient quality were identified. Therefore, the panel developed expert-opinion-based suggestions that are presented in this supplement using a modified Delphi process. The ultimate aim of the supplement is to expand the focus beyond the walls of ICUs to provide recommendations for the management of all critically ill or injured adults and children resulting from a pandemic or disaster wherever that care may be provided. Considerations for the management of critically ill patients include clinical priorities and logistics (supplies, evacuation, and triage) as well as the key enablers (systems planning, business continuity, legal framework, and ethical considerations) that facilitate the provision of this care. The supplement also aims to illustrate how the concepts of mass critical care are integrated across the spectrum of surge events from conventional through contingency to crisis standards of care.