tailieunhanh - Báo cáo y học: "The triage dilemma: opening Pandora’s box… ever so slowl"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: The triage dilemma: opening Pandora’s box ever so slowly. | Burkle Critical Care 2010 14 401 http content 14 1 401 CRITICAL CARE LETTER L_ The triage dilemma opening Pandora s box. ever so slowly Frederick M Burkle Jr See related research by Christian etal. http content 13 5 R170 I applaud the efforts by Michael Christian and colleagues 1 in taking on the difficult dilemmas surrounding triage management and training tied to surge capacity and resource allocation within intensive care settings during pandemics. Studies on triage protocols arose primarily from critical care professionals awakened to those responsibilities during severe acute respiratory syndrome and then re-challenged during the current H1N1 pandemic 2-4 . In reality intensive care units with their professional staff and high-tech equipment represent a major limiting factor for most communities. The most plausible scenario for a viral pathogen of greater severity and lethality is that emergency departments and hospital wards will be deluged with critical care patients the challenge being how to provide opportunities for survival by transferring some semblance of critical care services and expertise to these non-critical care settings. Discipline-directed triage management protocols will only be as important as the manner in which these tertiary level algorithms can be integrated into a larger system-wide triage scheme that begins at the primary triage care level and ends with whatever additional resources a regional support system can mobilize. Many uncomfortable but real decisions that have not to date been operationalized at the local level will be made. Triage management requires an infrastructure such as health emergency operations centers HEOCs where central triage committees operationalized ethical resources palliative care guidance data collection and analysis and communication capacities provide high-level situational awareness for simultaneously initiating triage and modifying protocols at all health facilities and their