New disaster preparedness strategy announced

New disaster proposal could legally protect physicians

In an unprecedented initiative, US and Canadian experts have developed a comprehensive framework to optimize and manage critical care resources during times of pandemic outbreaks or other mass critical care disasters. The new proposal suggests legally protecting clinicians who follow accepted protocols for the allocation of scarce resources when providing care during mass critical care events. The framework represents a major step forward to uniformly deliver sufficient critical care during catastrophes and maximize the number of victims who have access to potential life-saving interventions.

“Most countries, including the United States, have insufficient critical care resources to provide timely, usual care for a surge of critically ill and injured victims,” said Asha Devereaux, MD, FCCP, Task Force for Mass Critical Care. “If a mass casualty critical care event occurred tomorrow, many people with clinical conditions that are survivable under usual health-care system circumstances may have to forgo life-sustaining interventions due to deficiencies in supply, staffing, or space.” As a result, the Task Force for Mass Critical Care developed an emergency mass critical care (EMCC) framework for hospitals and public health authorities aimed to maximize effective critical care surge capacity.

Published as a supplement to the May issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians (ACCP), Definitive Care for the Critically Ill During a Disaster offers guidance for hospitals, medical professionals, and public health authorities on how to prepare for and provide essential critical care when the need for critical care resources far exceeds availability.

Expanding Critical Care Resources for a Disaster

To prepare for a mass critical care event, the task force proposes that hospitals with ICUs aim to meet several standards, including the ability to provide sufficient critical care for at least triple their usual ICU capacity and sustain this surge for up to 10 days without external assistance. Suggested surge capacity requirements include stockpiling medical equipment, including mechanical ventilators; optimizing medication; designating auxiliary critical care areas; and augmenting critical care staff.