Reorganising the pandemic triage processes to ethically maximise individuals' best interests

Intensive Care Medicine

Volumn 36, Issue 11, 2010, Pages 1966-1971

  Tillyard, Andrew ^a,b  

^a DERRIFORD HOSPITAL   (United Kingdom)

^b PENINSULA MEDICAL SCHOOL   (United Kingdom)

Author keywords

Pandemic; Triage; Virtue ethics

Indexed keywords

DECISION MAKING; EMERGENCY HEALTH SERVICE; INTENSIVE CARE UNIT; LAW; MEDICAL ETHICS; ORGANIZATIONAL STRUCTURE; PANDEMIC; REVIEW; SCORING SYSTEM; SEVERE ACUTE RESPIRATORY SYNDROME; SURVIVAL;

DELIVERY OF HEALTH CARE; EMERGENCY SERVICE, HOSPITAL; HUMANS; PANDEMICS; TRIAGE;

EID: 78650418296     PISSN: 03424642     EISSN: 14321238     Source Type: Journal    
DOI: 10.1007/s00134-010-1986-2     Document Type: Review

References (36)

1. Christian MD, Hawryluck L, Wax RS, Cook T, Lazar NM, Herridge MS, Muller MP, Gowans DR, Fortier W, Burkle FM (2006) Development of a triage protocol for critical care during an influenza pandemic. Can Med Assoc J 175:1377-1381
2. Department of Health (2009) Pandemic flu managing demand and capacity in health care organisations (surge). http://www.dh.gov.uk/ prod-consum-dh/groups/ dh-digitalassets/documents/digitalasset/ dh-098750.pdf. Accessed 22 Dec 2009
3. Jain S, Kamimoto L, Bramley AM, Schmitz AM, Benoit SR, Louie J, Sugerman DE, Druckenmiller JK, Ritger KA, Chugh R, Jasuja S, Deutscher M, Chen S, Walker JD, Duchin JS, Lett S, Soliva S, Wells EV, Swerdlow D, Uyeki TM, Fiore AE, Olsen SJ, Fry AM, Bridges CB, Finelli L, 2009 Pandemic Influenza A (H1N1) Virus Hospitalizations Investigation Team (2009) Hospitalised patients with 2009 H1N1 influenza in the United States, April-June 2009. N Engl J Med 361:1935-1944
4. The ANZIC Influenza Investigators (2009) Critical care services and 2009 H1N1 influenza in Australia and New Zealand. N Engl J Med 361:1925-1934
5. Kumar A, Zarychanski R, Pinto R, Cook DJ, Marshall J, Lacroix J, Stelfox T, Bagshaw S, Choong K, Lamontagne F, Turgeon AF, Lapinsky S, Ahern SP, Smith O, Siddiqui F, Jouvet P, Khwaja K, McIntyre L, Menon K, Hutchison J, Hornstein D, Joffe A, Lauzier F, Singh J, Karachi T, Wiebe K, Olafson K, Ramsey C, Sharma S, Dodek P, Meade M, Hall R, Fowler RA, Canadian Critical Care Trials Group H1N1 Collaborative (2009) Critically ill patients with 2009 influenza A(H1N1) infection in Canada. JAMA 302:1872-1879
6. Miller MA, Viboud C, Balinska M, Simonsen L (2009) The signature features of influenza pandemics-implications for policy. N Engl J Med 360:2595-2598
7. Bernat JL (2005) Definition, determination and disputes in critical care. Neurocrit Care 2:198-205
8. Angus DC, Marrie TJ, Obrosky DS, Clermont G, Dremsizov TT, Coley C, Fine MJ, Singer DE, Kapoor WN (2002) Severe community acquired pneumonia. Use of intensive care services and evaluation of American and British Thoracic Society guidelines. Am J Respir Crit Care Med 166:717-723
9. Woodhead M (2003) Assessment of illness severity in community acquired pneumonia: A useful new prediction tool? Thorax 58:371-372
10. Sinuff T, Adhikari NK, Cook DJ, Schünemann HJ, Griffith LE, Rocker G, Walter SD (2006) Mortality predictions in the intensive care unit: Comparing physicians with scoring systems. Crit Care Med 34:878-885
11. McNarry AF, Goldhill DR (2004) Intensive care admission decisions for a patient with limited survival prospects: A questionnaire and database analysis. Intensive Care Med 30:325-330
12. Holloway RG, Benesch CG, Burgin WS, Zentner JB (2005) Prognosis and decision making in severe stroke. JAMA 294:725-733
13. Rodriguez RM, Wang NE, Pearl RG (1997) Prediction of poor outcome of intensive care unit patients admitted from the emergency department. Crit Care Med 25:1801-1806
14. Frick S, Uehlinger DH, Regula M, Zenklusen Z (2003) Medical futility: Predicting outcome of intensive care unit patients by nurses and doctors-a prospective comparative study. Crit Care Med 31:456-461
15. Giannini G, Consonni D (2006) Physicians perceptions and attitudes regarding inappropriate admissions and resource allocation in the intensive care setting. Br J Anaesth 96:57-62
16. Department of Health (2007) Pandemic flu: A national framework for responding to an influenza pandemic. http://www.dh.gov.uk/en/ Publicationsandstatistics/Publications/ PublicationsPolicyAndGuidance/ DH-080734. Accessed 22 Dec 2009
17. Goldhill D, Sumner A (1998) APACHE II data accuracy and outcome prediction. Anaesthesia 53:937-943
18. Poldermans K, Girbes ARJ, Thijs LG, Strack van Schijndel RJM (2001) Accuracy and reliability of APACHE II scoring in two intensive care units. Anaesthesia 56:47-50
19. Jones AE, Fitch MT, Kline JA (2005) Operational performance of validated physiologic scoring systems for predicting in-hospital mortality among critically ill emergency department patients. Crit Care Med 33:974-978
20. Alvarez M, Nava JM, Rue M, Quintana S (1998) Mortality predication in head trauma patients: Performance of Glasgow coma score and general severity systems. Crit Care Med 26:142-146
21. Nguyen HB, Rivers EP, Havstad S, Knoblich B, Ressler JA, Muzzin AM, Tomlanovich MC (2008) Critical care in the emergency department: A physiologic assessment and outcome evaluation. Acad Emerg Med 7:1354-1361
22. Schuetz P, Koller M, Christ-Crain M, Steyerberg E, Stolz D, Müller C, Bucher HC, Bingisser R, Tamm M, Mü ller B (2008) Predicting mortality with pneumonia severity scores: importance of model recalibration to local settings. Epidemiol Infect 136:1628-1637
23. Aujesky D, Auble TE, Yealy DM, Stone RA, Obrosky DS, Meehan TP, Graff LG, Fine JM, Fine MJ (2005) Prospective comparison of three validated rules for prognosis in community-acquired pneumonia. Am J Med 118:384-392
24. Ioachimescu OC, Ioachimescu AG, Iannini PB (2004) Severity scoring in community acquired pneumonia caused by Streptococcus pneumoniae: A 5-year experience. Int J Antimicrob Agents 24:485-490
25. Buising KL, Thursky KA, Black JF, MacGregor L, Street AC, Kennedy MP, Brown GV (2006) A prospective comparison of severity scores for identifying patients with severe community acquired pneumonia: reconsidering what is meant by severe pneumonia. Thorax 61:419-424
26. Jones AE, Trzeciak S, Kline JA (2009) The sequential organ failure assessment score for predicting outcome in patients with severe sepsis and evidence of hypoperfusion at the time of emergency department presentation. Crit Care Med 37:649-654
27. Okie S (2008) Dr. Pou and the hurricane implications for patient care during disasters. N Engl J Med 358:1-5
28. General Medical Council (2009) Pandemic influenza: good medical practice. Responsibilites of doctors in a national pandemic. http://www.gmc-uk. org/GMP-in-pandemic-draft-23Oct09.pdf-27941326.pdf. Accessed 22 Dec 2009
29. England and Wales Department of Health (2007) Mental capacity act 2005. Code of practice. http://www.dca.gov.uk/legal-policy/ mental-capacity/mca-cp. pdf. Accessed 22 Dec 2009
30. Coombes R (2009) Doctors call for guidance on how to prioritise critically ill patients in swine flu pandemic. Br Med J 339:3092
31. MacIntyre A (2007) After virtue, 3rd edn. University of Notre Dame Press, Notre Dame
32. Shelton W (1999) Can virtue be taught. Acad Med 74:671-674
33. Larkin GL, Arnold J (2003) Ethical considerations in emergency planning, preparedness, and response to acts of terrorism. Prehosp Disaster Med 18:170-178
34. ICNARC (2009) SwiFT: Study outline and dataset. https://www.icnarc.org/ documents/ SwiFT%20study%20 outline%20and%20dataset.pdf. Accessed 22 Dec 2009
35. Pelligrino EM (1990) The medical profession as a moral community. Bull N Y Acad Med 66:221-232
36. Pahlman I, Tohmo H, Gylling H (2009) Pandemic influenza: human rights, ethics and duty to treat. Acta Anaesthesiol Scand 54:9-15