CHEST Guidelines-Triage-of-Scarce-Critical-Care-Resources-in-COVID- (1)

Triage-of-Scarce-Critical-Care-Resources-in-COVID- (1)

Pdf Summary

The guide titled "Triage of Scarce Critical Care Resources in COVID-19" addresses the overwhelming demands on health systems during the COVID-19 pandemic, specifically focusing on the allocation of critical care resources when capacity is exceeded. Developed by a task force comprising experts from various institutions and endorsed by critical care organizations, the guide outlines the implementation of triage systems in times of resource scarcity.<br /><br />The core purpose of a triage system is to allocate limited resources, such as ventilators and medication, to patients who are most likely to benefit from them. The guide emphasizes that such a system should only be deployed as a last resort after exhausting all other options to increase capacity, such as expanding surge capacity, moving patients, or reallocating resources from less impacted regions. It maintains that any triage system needs to uphold ethical principles, including fairness, respect for individuals, and social justice.<br /><br />The document describes operational steps to implement triage, outlining the responsibilities of stakeholders like health facilities and regional authorities. Key actions include inventorying resources, creating regional triage committees, and developing protocols to maximize benefits. Legal and regulatory frameworks must permit triage decision-making without patient consent, ensuring that decisions are anchored in transparency and equity.<br /><br />Furthermore, the guide highlights the need for supportive care for patients not receiving critical services, emphasizing continuous reassessment and communication with families. It also focuses on safeguarding the emotional and psychological well-being of healthcare workers facing moral injury and burnout, exacerbated by crises like COVID-19.<br /><br />This framework aims to assist communities in fairly meeting the clinical needs of the largest number of patients while minimizing the necessity of scarce resource allocation. The goal is to maintain public trust through transparent communication and adapted standards of care during unprecedented health emergencies.

Keywords

COVID-19

critical care

resource allocation

triage system

ethical principles

healthcare workers

public trust

surge capacity

social justice

emotional well-being