RT Journal Article
SR Electronic
T1 Development of a triage protocol for critical care during an influenza pandemic
JF Canadian Medical Association Journal
JO CMAJ
FD Canadian Medical Association
SP 1377
OP 1381
DO 10.1503/cmaj.060911
VO 175
IS 11
A1 Michael D. Christian
A1 Laura Hawryluck
A1 Randy S. Wax
A1 Tim Cook
A1 Neil M. Lazar
A1 Margaret S. Herridge
A1 Matthew P. Muller
A1 Douglas R. Gowans
A1 Wendy Fortier
A1 Frederick M. Burkle
YR 2006
UL http://www.cmaj.ca/content/175/11/1377.abstract
AB Background: The recent outbreaks of avian influenza (H5N1) have placed a renewed emphasis on preparing for an influenza pandemic in humans. Of particular concern in this planning is the allocation of resources, such as ventilators and antiviral medications, which will likely become scarce during a pandemic. Methods: We applied a collaborative process using best evidence, expert panels, stakeholder consultations and ethical principles to develop a triage protocol for prioritizing access to critical care resources, including mechanical ventilation, during a pandemic. Results: The triage protocol uses the Sequential Organ Failure Assessment score and has 4 main components: inclusion criteria, exclusion criteria, minimum qualifications for survival and a prioritization tool. Interpretation: This protocol is intended to provide guidance for making triage decisions during the initial days to weeks of an influenza pandemic if the critical care system becomes overwhelmed. Although we designed this protocol for use during an influenza pandemic, the triage protocol would apply to patients both with and without influenza, since all patients must share a single pool of critical care resources.