Who should receive care in a pandemic?

By Jenny Bush, RRT-NPS, RPFT, CCM

This question has been asked and reviewed by several government agencies and professional medical groups.

Just to review in Nebraska there are six medical response systems.  Each is reflective of the areas that they represent.  A map and contact information for the program coordinators is located.

http://www.nemedicalresponse.com/

I recommend Nebraska respiratory therapists in their respective areas contact their program coordinator to participate and add respiratory expertise to your areas disaster planning.  Tell them who you are, what medical group you represent and that you are available to help your community.  Each system in Nebraska has been given authority to act for the benefit of their populations.

Last year I sent out information to the response systems and therapists involved in disaster and pandemic planning.  A follow up has been requested.

In a May 2008 article by the Associated Press the follow was stated: “Doctors know some patients needing lifesaving care won’t get it in a flu pandemic or other disaster. The gut-wrenching dilemma will be deciding who to let die.” http://www.msnbc.msn.com/id/24454529/

A series of discussions were held with physicians and other medical personnel regarding decision making in a pandemic.

I have included some of the links for discussion and rationale, but each response system needs evaluate what they would do in this situation.

You can find the differing rationale in the links listed below.  The triage goals follow basically three criteria. These are my observations from the research I have made.

  • Severity and recoverability of illness.
  • Can this patient participate in pandemic recovery?  Are they of an age to be able to work or help people in this environment?  This patient may be a respiratory therapist in your community.
  • All things being equal and the victims do not fall into the above criteria, then first come, first served as resources allow.

Below are some of the resources that address triage in a disaster or pandemic scenario.  Each region with their respective medical professionals need to determine for their community what this means and how it would be implemented if the situation became imminent.  A discussion with regional care providers is important.

Development of triage protocols in a pandemic – you can get the abstract here.  Check with your medical staff for access to the full documents.

http://www.cmaj.ca/cgi/content/abstract/175/11/1377

http://ccforum.com/content/11/2/212/abstract/

Patient triage during pandemic influenza

http://www.birdflumanual.com/articles/patTriage.asp

Pandemic Flu preparedness: Ethical issues and recommendations.  Indiana State Department of Health.

http://www.bioethics.iu.edu/pandemicFluPrep_2007.pdf

Thanks for your time.  If you have any questions you can contact Jenny at jbush@nebraskamed.com.


Switch to our mobile site