How to prepare Intensive Care Unit to respond in crisis?

Mohamed Abdel Rahman Ahmed Abdel Rahman


Preparedness is essential for successful disaster response. Because ICUs face many competing priorities, without defining “preparedness for what,” the task can seem overwhelming. Knowing the ideal standers for ICU is essential before getting prepared for mass causalities .as we can't but burdens on units full of burdens. Estimation of Expected number and types of mass causalities is milestone in deal with such condition. Categorization of disasters is based on the number of causalities and determining hospital response. Dual wave phenomenon is another method by CDC to estimate number of expected causalities. Alteration of medical services to Essential Mass Critical Care of Emergency (EMCCM) is essential in mass causality incident. Incidence command system (ICS) is organizational shape to manage and combat the disasters. To prepare ICU to respond in crisis we shall understand this issue:  Incidence command system.  Initial response.  Pre Disaster planning checklist.  Recommendations for hospital planning and response for emergency mass critical care.  Surge capacity.  Triage.  Palliation. Experience has shown that bed capacity is often the rate limiting step in caring for causalities. This is especially true for intensive care beds since these are often running at, or close to, maximum capacity during normal daily hospital operations. Triage is beneficial in the disaster response: • Triage separates out those who need rapid medical care to save life or limb. The worldwide triage methods used are • START (Simple Triage and Rapid Transport) • SALT (Sort-Assess-Lifesaving-Interventions-Treatment/ Transport) Bioterrorist and epidemic infection attacks may be covert and could result in hundreds, thousands, or more critically ill victims. Critical care will play a key role in decreasing morbidity and mortality rates after a bioterrorist or epidemic infection attack. Triage algorithms have been designed and validated for mass casualty traumatic injuries but are not designed or intended to help categorize the likelihood of survival of critically ill in bioterrorism. There is a Need for invent triage system for bioterrorism and pandemic infection. Mass causalities carry risk to develop too much patient needing mechanical ventilation which already in shortage and exhaustion. Stockpiling Ventilators in a Central Warehouse and distribution of ventilators over the hospitals facing MCI is two strategies carry much debate. Ventilator triage protocol intended for use only during a mass casualty event, proclaimed as a public health emergency by health authority it would be characterized by frequent, widespread cases of respiratory failure occurring in sufficient volume to quickly exhaust available mechanical ventilator resources. Ventilator triage should be implemented in a tiered or stepwise fashion, and after declaration of respiratory distress mass emergency.

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Other Titles كيفية تحضير وحدة الرعاية المركزة للإستجابة في الأزمات
Issue Date 2016

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