New disaster preparedness strategy announced

Trigger Event and Process

Prior to the rationing of critical care resources, hospitals and surrounding areas must first experience a “trigger” event that includes a declared state of emergency and lack of critical equipment or infrastructure. The decision to initiate EMCC must occur in conjunction with local and regional Medical Emergency Operations Command authority and not by individual hospitals.

Critical Care Resource Allocation

The task force advises rationing scarce critical care resources only after surge capacity has been exceeded and all attempts to use outside resources have been made. Under these circumstances, the task force proposes a formal EMCC triage and resource allocation protocol. Examples of the protocol include:

• The hospital triage officer/team will assess and prioritize all patients for receipt of scarce interventions using objective medical criteria.
  
  
• Palliative care for all patients will be a priority. However, patients will be ineligible for scarce critical care interventions if they have extreme organ failure and/or severe chronic illness with a short life expectancy.
  
  
• Critical care resources will not be preferentially distributed to any specific population group.
  
  
• Decisions regarding resource allocation will be documented, remain transparent, occur uniformly across all affected regions, and subject to rigorous quality assurance.
  
  

“Ideally, having an emergency mass critical care plan in place would prevent hospitals from needing to ration critical care resources,” said Lewis Rubinson, MD, PhD, Task Force for Mass Critical Care. “However, if the surge capacity is exceeded, the use of emergency mass critical care triage and rationing will help local health-care facilities minimize mortality and optimize survival.”

Physician Liability