CHEST Guidelines-Introduction-and-Executive-Summary

Introduction-and-Executive-Summary_chest

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The document is a supplement from the journal CHEST, dated October 2014, created by the CHEST Consensus Task Force on Mass Critical Care. It discusses preparedness and response strategies for managing critically ill and injured patients during pandemics and disasters. The consensus involves expert opinion due to a lack of high-quality studies, steering away from evidence-based recommendations. <br /><br />Key objectives include expanding the focus beyond Intensive Care Units (ICUs) to cover all relevant care settings. The document outlines strategies for clinical priorities, logistics (including supplies, evacuation, and triage), and essential systems planning, ensuring business continuity, legal framework, and ethical considerations facilitate care provision during pandemics or disasters. <br /><br />The consensus recognizes different responses from conventional to crisis care, focusing on surge capacity expansion by up to 200% of baseline capacity in response to crises, including stockpiling necessary equipment and engaging in regional planning. It emphasizes engaging government and health systems, integrating critical care in disaster plans, ensuring resource allocation parity, including for special populations, and considering ethical and legal frameworks surrounding care delivery in crisis situations. <br /><br />The document stresses the need for robust communication systems within health-care coalitions, ensuring business continuity, enhancing information technology readiness, and process improvement through simulation exercises. It calls for engaging critical care leaders in disaster planning and clinician education. Emphasis on ethical considerations, like triage systems, crisis standards of care, and responder safety, is critical for executing these plans effectively. Legal preparedness includes developing MCC plans integrated with existing crisis standards and ensuring liability protections for providers. <br /><br />Finally, the document advocates international cooperation and strategic planning to bolster resource-poor settings, emphasizing infrastructure strengthening and leveraging expertise for enhanced disaster response capacity.

Keywords

Mass Critical Care

pandemics

disasters

preparedness

response strategies

surge capacity

ethical considerations

legal framework

resource allocation

international cooperation