The recent outbreaks of avian influenza (H5N1) around the world have placed a renewed emphasis on preparing for an influenza pandemic in humans. As we saw with SARS, any catastrophic outbreak of infectious disease will have profound effects on the availability and delivery of health care services and the functioning of health care institutions. Christian and coauthors have applied a collaborative process using best evidence, expert panels, stakeholder consultations and ethical principles to develop a triage protocol for prioritizing access to critical care resources, including ventilators and antiviral medications, during a pandemic. This protocol is intended to provide guidance for making triage decisions during the initial days to weeks of an influenza pandemic if the critical care system becomes overwhelmed. The protocol would apply to all patients, not just those with influenza. In a related commentary, Melnychuk and Kenny discuss the many ethical challenges that arise during the development of triage protocols.
p. 1377 Development of a triage protocol for critical care during an influenza pandemic
-- M.D. Christian et al
http://www.cmaj.ca/pressrelease/pg1377.pdf
p. 1393 Pandemic triage: the ethical challenge
-- R.M. Melnychuk, N.P. Kenny
http://www.cmaj.ca/pressrelease/pg1393.pdf
Canadian Medical Association Journal