T he number of deaths related to opioid overdose has increased substantially in North America over the past decade. 1,2 In British Columbia, there were 374 fentanyl-related overdose deaths between January and October 2016, an increase of 194% over the same period in 2015. 3 Acute care centres and emergency departments have been proposed as potential drivers of this epidemic, [4][5][6][7] including in a recent longitudinal study in Ontario that showed that patients who received opioid prescriptions in the emergency department had a higher risk of admission for opioid toxicity over 2 years. 5 With its high patient volume and lack of a preexisting patientprovider relationship, the emergency department has been identified as a possible location where opioid use disorders may develop, with upward of 29% of those misusing opioids having been initially exposed in this setting. [5][6][7] The number of opioids prescribed during emergency depart-ment visits in the United States rose substantially over 2001-2010 and continues to trend upward. 8 The increase in opioid prescriptions has been attributed to numerous factors including aggressive marketing by pharmaceutical companies, the desire to minimize acute and chronic pain, and a lack of discussion between prescribers and patients
The coronavirus disease 2019 (COVID-19) pandemic raised the possibility of overwhelming demand for critical care resources, necessitating the creation of resource allocation frameworks. • The working group who developed Saskatchewan's resource allocation framework were guided by the ethical principles of transparency, consistency, accountability, proportionality and responsiveness. Competing interests: Oksana Prokopchuk-Gauk has received consultant fees from Celgene and Takeda, an honorarium from Canadian Blood Services, and remuneration for conference travel from Octapharma; she is the chair of the National Advisory Committee on Blood and Blood Products, and co-chair of the National Emergency Blood Management Committee. No other competing interests were declared. This article has been peer reviewed.
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