CHEST Guidelines-Triage-of-Scarce-Critical-Care-Resources-in-COVID-

Triage-of-Scarce-Critical-Care-Resources-in-COVID-

Pdf Summary

The "Triage of Scarce Critical Care Resources in COVID-19" report from the Task Force for Mass Critical Care and the American College of Chest Physicians provides a comprehensive guide for allocating limited medical resources during the COVID-19 pandemic. The purpose is to ensure that critical care, such as mechanical ventilation, reaches patients most likely to benefit, amidst overwhelming demand that outstrips hospital capacity.<br /><br />Key principles of triage systems outlined in the report include transparency, coordination among health systems, and adherence to ethical standards that prioritize beneficence, nonmaleficence, equity, and social justice. Triage systems should be implemented as a last resort after all efforts to surge capacity, move patients, or shift resources have been made.<br /><br />The report emphasizes the importance of reassessing patients regularly, providing the best possible care for those unable to receive critical care, and addressing palliative needs whenever applicable. Triage protocols should be flexible, taking into account changes in resource availability and patient condition.<br /><br />Infrastructure, processes, and adequate training are vital for effective triage, as is collaboration among hospitals to ensure consistency. The plan calls for legal adjustments to allow deviations from standard consent protocols, as well as strong communication strategies to maintain public trust and transparency.<br /><br />Support structures are necessary for healthcare workers (HCWs) to manage moral distress and burnout exacerbated by crisis situations. Institutions should provide debriefing opportunities and strategies for psychological resilience.<br /><br />In the pediatric context, the triage framework must account for the unique needs of children, integrating them into regional triage plans while respecting family dynamics. Overall, the report aims to equip communities globally with the tools to handle patient needs equitably when resources are scarce.

Keywords

COVID-19

critical care

triage systems

resource allocation

ethical standards

palliative care

healthcare infrastructure

psychological resilience

pediatric triage

public trust