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dc.contributor.authorDichter, Jeffrey R
dc.contributor.authorDevereaux, Asha V
dc.contributor.authorSprung, Charles L
dc.contributor.authorMukherjee, Vikramjit
dc.contributor.authorPersoff, Jason
dc.contributor.authorBaum, Karyn D
dc.contributor.authorOrnoff, Douglas
dc.contributor.authorUppal, Amit
dc.contributor.authorHossain, Tanzib
dc.contributor.authorHenry, Kiersten N
dc.contributor.authorGhazipura, Marya
dc.contributor.authorBowden, Kasey R
dc.contributor.authorFeldman, Henry J
dc.contributor.authorHamele, Mitchell T
dc.contributor.authorBurry, Lisa D
dc.contributor.authorMartland, Anne Marie O
dc.contributor.authorHuffines, Meredith
dc.contributor.authorTosh, Pritish K
dc.contributor.authorDownar, James
dc.contributor.authorHick, John L
dc.contributor.authorChristian, Michael D
dc.contributor.authorMaves, Ryan C
dc.date.accessioned2021-09-14T16:30:55Z
dc.date.available2021-09-14T16:30:55Z
dc.date.issued2021-09-06
dc.identifier.urihttp://hdl.handle.net/10713/16653
dc.description.abstractBackground: Following the publication of 2014 consensus statement regarding mass critical care during public health emergencies, much has been learned about surge responses and the care of overwhelming numbers of patients during the COVID-19 pandemic. Gaps in prior pandemic planning were identified and require modification in the midst of ongoing surge throughout the world. Methods: The Task Force for Mass Critical Care (TFMCC) adopted a modified version of established rapid guideline methodologies from the World Health Organization and the Guidelines International Network-McMaster Guideline Development Checklist. With a consensus development process incorporating expert opinion to define important questions and extract evidence, TFMCC developed relevant pandemic surge suggestions in a structured manner, incorporating peer-reviewed literature, “gray” evidence from lay media sources, and anecdotal experiential evidence. Results: Ten suggestions were identified regarding staffing, load-balancing, communication, and technology. Staffing models are suggested with resilience strategies to support critical care staff. Intensive care unit (ICU) surge strategies and strain indicators are suggested to enhance ICU prioritization tactics to maintain contingency level care and avoid crisis triage, with early transfer strategies to further load-balance care. We suggest intensivists and hospitalists be engaged with the incident command structure to ensure two-way communication, situational awareness, and the use of technology to support critical care delivery and families of patients in intensive care units (ICUs). Conclusions: A subcommittee from the Task Force for Mass Critical Care offers interim evidence-informed operational strategies to assist hospitals and communities to plan for and respond to surge capacity demands from COVID-19.en_US
dc.description.urihttps://doi.org/10.1016/j.chest.2021.08.072en_US
dc.description.urihttp://www.ncbi.nlm.nih.gov/pmc/articles/pmc8420082/en_US
dc.language.isoenen_US
dc.publisherElsevier Ltd.en_US
dc.relation.ispartofChesten_US
dc.rightsCopyright © 2021. Published by Elsevier Inc.en_US
dc.subjectCOVID-19en_US
dc.subjectContingencyen_US
dc.subjectConventionalen_US
dc.subjectCrisis levelsen_US
dc.subjectCritical Clinical Prioritizationen_US
dc.subjectIncident Command Systemen_US
dc.subjectLoad-Balancingen_US
dc.subjectMass Critical Careen_US
dc.subjectStaffingen_US
dc.subjectSurgeen_US
dc.subjectTelemedicineen_US
dc.subjectTiered staffingen_US
dc.titleMass Critical Care Surge Response during COVID-19: Implementation of Contingency Strategies A Preliminary Report of findings from the Task Force for Mass Critical Careen_US
dc.typeArticleen_US
dc.identifier.doi10.1016/j.chest.2021.08.072
dc.identifier.pmid34499878
dc.source.countryUnited States


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