CHEST Guidelines-Surge-Capacity-Logistics

Surge-Capacity-Logistics_chest

Pdf Summary

The CHEST Consensus Statement discusses strategies for managing critically ill and injured during pandemics and disasters, focusing on surge capacity logistics to deliver mass critical care (MCC). It underlines the necessity for pre-existing plans to address surges in intensive care capacity by coordinating strategies across hospital and regional levels. The statement, developed by expert panels, provides 22 suggestions in several domains: systems issues, equipment, staffing, and informatics, despite the limited evidence base.<br /><br />The recommendations include establishing interoperable and compatible stockpiles of critical equipment and pharmaceuticals at regional levels to ensure a uniform response. Hospitals are encouraged to maintain disaster supply caches, accommodate unique population needs, and include supportive services like pharmacy and respiratory therapy in surge planning. Adaptive staffing measures, comprehensive role definition, incident command integration, and cross-training are recommended to address staff shortages and enhance preparedness.<br /><br />The document also emphasizes the importance of roles and systems in effective care delivery, including revised nurse-to-patient ratios and physician oversight. Telemedicine and remote consultation are suggested to extend critical care reach. Deployable critical care services, although temporary, are presented as interim solutions when hospital infrastructure is compromised. The importance of well-coordinated patient flow, early ICU patient discharge, and reverse triage is highlighted to improve capacity handling.<br /><br />Transportation logistics suggest the effective use of assets to support care delivery, emphasizing patient stabilization and the transfer of medical resources to site-specific scenarios when patient transport is risky. Finally, regional coalitions among hospitals are recommended to leverage shared resources and maximize critical care capabilities, ensuring continuous learning and adaptation through iterative plan development and review.<br /><br />Overall, it robustly identifies the critical cross-functional collaboration required among administrations, governments, and healthcare practitioners to efficiently manage the significant challenges posed by pandemics and disaster scenarios.

Keywords

pandemics

disasters

surge capacity

mass critical care

interoperable stockpiles

adaptive staffing

telemedicine

regional coalitions

cross-functional collaboration

critical care logistics