Year: 2023
Type: article
Abstract: In natural disasters, pandemics, war, and conflict, health care practitioners must often allocate limited critical care resources among many patients in need of treatment. Allocation methods are fraught with ethical and legal challenges compromised not only by medical uncertainty in an individual's likelihood of survival and the ensuing quality and length of life should they survive, but by the unpredictability of the unfolding disaster. Decisions must be made urgently, however, and in real-time. In response, US states developed pandemic preparedness plans (PPPs) to formalize triage decisions. In the article, "Triage Procedures for Critical Care Resource Allocation During Scarcity," 1 Ennis and colleagues systematically reviewed current state-based PPPs to determine whether and how comorbidities and likelihood of postdischarge survival factored into state-based triage procedures. Of 32 state PPPs that met inclusion criteria, 20 categorically excluded or deprioritized patients with certain listed comorbid conditions, often weighted by condition severity, and 21 included variations of survival predictions into the triage determination. Given the substantial variability in approach, the authors call for states to revisit their PPPs, greater transparency in and access to those PPPs, and a national effort to develop and align triage tools while ensuring civil rights protections.
Source: JAMA Network Open
Authors: Barbara E. Bierer, Robert D. Truog
Language: English
Subfield: Emergency Medical Services
Field: Health Professions
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,000
OpenAlex ID: W4386256746