CHEST Guidelines-Surge-Capacity-Principles

Surge-Capacity-Principles_chest

Pdf Summary

The "CHEST Consensus Statement: Care of the Critically Ill and Injured During Pandemics and Disasters" provides guidelines for expanding critical care surge capacity in response to pandemics and disasters. The article outlines principles and frameworks for enhancing intensive care services, focusing on settings in developed countries. Here are key points from the article:

1. <strong>Surge Planning and Execution</strong>: Critical care experts should be integral in disaster planning committees to optimize surge capacity. The article categorizes response strategies into conventional, contingency, and crisis care, each with specific capacity targets: conventional care can expand resources by 20%, contingency care by 100%, and crisis care by 200% using various resources.

2. <strong>Situational Awareness</strong>: Facilities and coalitions must enhance information sharing through robust IT support to improve the tracking and management of resources. Real-time data sharing boosts situational awareness and aids decision-making during crises.

3. <strong>Planning for Special Populations</strong>: Hospitals should be able to stabilize unique populations, such as pediatric or trauma patients, initially unwanted by specialty hospitals. Access to specialized expertise and regional planning participation is crucial for effective crisis response.

4. <strong>Service De-escalation</strong>: In scenarios demanding a resource reallocation for broader benefit, hospitals may need to orchestrate a controlled reduction of services—"engineered failure"—to better manage available resources.

5. <strong>Research and Development</strong>: Future guidelines should be informed by rigorous evidence and research, particularly in developing realistic surge capacity targets and improving communication systems during disasters.

The article emphasizes collaborations among healthcare institutions, government entities, and public health systems to ensure that critical care services can respond effectively to disasters and pandemics. Planning should also account for prolonged critical care demands and integrate community support systems to mitigate reliance on hospital resources. These measures collectively aim to reduce mortality and optimize resource utilization during mass casualty events.

Keywords

critical care

pandemics

disasters

surge capacity

situational awareness

special populations

service de-escalation

research and development

resource utilization

mass casualty events