PT  - JOURNAL ARTICLE
AU  - Michael D. Christian
AU  - Laura Hawryluck
AU  - Randy S. Wax
AU  - Tim Cook
AU  - Neil M. Lazar
AU  - Margaret S. Herridge
AU  - Matthew P. Muller
AU  - Douglas R. Gowans
AU  - Wendy Fortier
AU  - Frederick M. Burkle
TI  - Development of a triage protocol for critical care during an influenza pandemic
AID  - 10.1503/cmaj.060911
DP  - 2006 Nov 21
TA  - Canadian Medical Association Journal
PG  - 1377--1381
VI  - 175
IP  - 11
4099  - http://www.cmaj.ca/content/175/11/1377.short
4100  - http://www.cmaj.ca/content/175/11/1377.full
SO  - CMAJ2006 Nov 21; 175
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.