All Title Author
Keywords Abstract

Critical Care  2013 

Critical care resource allocation: trying to PREEDICCT outcomes without a crystal ball

DOI: 10.1186/cc11842

Full-Text   Cite this paper   Add to My Lib


The International Forum of Acute Care Trialists (InFACT) was formed in 2009 and provided a platform for international critical care research collaboration during the 2009/10 influenza A(H1N1) pandemic [12]. Over the past 2 years, a number of working groups have emerged from InFACT focused upon improving the investigation and care of patients with severe respiratory illness. Arising from these efforts, in June 2012 an inter-national group of clinicians convened the first meeting of the Providing Resources for Effective and Ethical Decisions In Critical Care Triage (PREEDICCT) Study Group. The study group's aim is to develop decision support tools appropriate for triaging critically ill adult patients during epidemics, mass-casualty scenarios or other resource-limited settings. This meeting identified a number of knowledge gaps and research priorities in this area, and suggested a revised framework for the requirements of an adequate triage decision support tool.While purpose-built triage protocols focus on specific events (for example, pandemics), resource allocation decisions are part of everyday practice for critical care physicians worldwide. Several PREEDICCT members work in settings where there are chronically insufficient critical care resources to meet the demand [13]. Critical care physicians also make resource allocation decisions every day in high-income countries, as they decide who might benefit from ICU care, when to accept outside transfers and when insufficient capacity dictates external transfer of patients. Yet intensivists lack objective tools to support these decision-making processes. Further, practices and specific decisions are likely to vary widely by country, by hospital and by individual provider.The first significant shift in direction advocated by our group is to move away from attempting to use a physiologic score alone to predict outcomes. The rationale for basing triage tools on a physiologic score is that all critically ill patients com


comments powered by Disqus