Thursday, September 24, 2009

Compilation: H1N1 and ICU prioritization plans resources

Here are some approaches that have been suggested for how to prioritize limited ICU resources in a case of a mass casualty/pandemic situation. Some of the key points are:
1. Need to codify these protocols prior to the actual event, so as to maximize efficiency and minimize chaos
2. It is desirable to get community buy-in
3. Broad adoption is also needed to avoid litigation downstream

Here are some resources:
1. The Canadian protocol
2. American College of Chest Physicians disaster preparedness presentation
3. Recent joint MA DPH and HSPH statement on altered standards during a pandemic
4. Critical care during epidemics
5. Allocation of vents in a public health disaster (from NYC DPH)
6. SCCM podcast from Dr. Randy Wax
7. Chest Journal supplement: Definitive care for the critically ill during a disaster
8. Canadian Pandemic Resources for Critical Care
9. NYS DOH draft document on ventilator allocation (hat tip to Scott Hensley)

And here are a few posts on this blog that have discussed some of the issues:
1. Imagination and H1N1 preparedness
2. A narrowing window of opportunity
3. H1N1: Why we are unprepared
4. H1N1 predictions demystified
5. Notes from a pandemic

This is by no means an exhaustive list, but just some stuff I could come up with off the top of my head. Please, feel free to suggest other relevant resources in your comments.


  1. Here's a link to the NYS DOH draft: