Evidence-Based Pediatric Outcome Predictors to Guide the Allocation of Critical Care Resources in a Mass Casualty Event*

Toltzis, Philip; Soto‐Campos, Gerardo; Kuhn, Evelyn M.; Hahn, Ryan; Kanter, Robert K.; Wetzel, Randall C.

doi:10.1097/pcc.0000000000000481

Cited by 22 publications

(9 citation statements)

References 22 publications

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“…Recently VPS data have been used to develop a unique, data-driven methodology for disaster triage. 32 Finally an extension of the use of ICU data to examine quality issues has recently been reported using the Society of Thoracic Surgeons (STS) and public health information system databases to demonstrate that there is a relationship between high-quality outcomes as measured by standardized mortality and decreased cost of careconfirming what we believe-quality care costs less. 33 Fig.…”

Section: Comparing Quality and Benchmarkingmentioning

confidence: 91%

Pediatric Intensive Care Databases for Quality Improvement

Wetzel

2015

J Pediatr Intensive Care

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The availability and breadth of collected data has grown exponentially in pediatric critical care medicine. This growth is driven by the practitioners' desire to understand and improve practice. In this manuscript, the author details the registry design factors that must be considered to meet quality improvement and safety needs in pediatric critical care units. The challenges to maintain a high standard database and data on health care delivery performances using the VPS registry data are provided.

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Section: Comparing Quality and Benchmarkingmentioning

confidence: 91%

Pediatric Intensive Care Databases for Quality Improvement

Wetzel

2015

J Pediatr Intensive Care

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“…This work evolved from a request by the State of Ohio to construct such an algorithm to augment their disaster readiness planning. We previously have derived prediction equations for probability of death (POD) and days on mechanical ventilation (DV) for children admitted to the PICU (16). The present study extends this work by simulating a pandemic crisis.…”

mentioning

confidence: 89%

Pediatric Triage in a Severe Pandemic: Maximizing Survival by Establishing Triage Thresholds*

Gall¹,

Wetzel

Kolker³

et al. 2016

Critical Care Medicine

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“…However, with rapidly increasing and sustained demand such measures might be insufficient, and the need for resources may rapidly exceed capacity. In this situation, healthcare systems need to have evidence-based, equitable, and publicly defensible policies in place on how to ration potentially life-saving treatments [10,11]. Rules to guide allocation of life sustaining treatments will need to incorporate ethical considerations such as social justice, non-prejudice, prevention of preferential treatment of population subgroups, and be transparent to clinicians and the public to prevent moral distress and outrage.…”

Section: Introductionmentioning

confidence: 99%

Supporting decision-making on allocation of ICU beds and ventilators in pandemics

Cardona

Dobler

Koreshe

et al. 2020

Preprint

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As the world struggles with the COVID-19 pandemic, health service demands have increased to a point where healthcare resources may prove inadequate to meet demand. Guidelines and tools on how to best allocate intensive care beds and ventilators developed during previous epidemics can assist clinicians and policy-makers to make consistent, objective and ethically sounds decisions about resource allocation when healthcare rationing is inevitable. This scoping review of 62 published guidelines, triage protocols, consensus statements and prognostic tools from crisis and non-crisis situations sought to identify a multiplicity of objective factors to inform healthcare rationing of critical care and ventilator care. It also took ethical considerations into account. Prognostic indicators and other decision tools presented here can be combined to create locally-relevant triage algorithms for clinical services and policy makers deciding about allocation of ICU beds and ventilators during a pandemic. Community awareness of the triage protocol is recommended to build trust and alleviate anxiety among the public. This review provides a unique resource and is intended as a discussion starter for clinical services and policy makers to consider formalising an objective triage consensus document that fits the local context.

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Evidence-Based Pediatric Outcome Predictors to Guide the Allocation of Critical Care Resources in a Mass Casualty Event*

Abstract: An evidence-based predictive tool for children is presented to guide resource allocation during Crisis Standards of Care, potentially improving population outcomes by selecting patients likely to benefit from short-duration ICU interventions.

Cited by 22 publications

References 22 publications

Pediatric Intensive Care Databases for Quality Improvement

Pediatric Intensive Care Databases for Quality Improvement

Pediatric Triage in a Severe Pandemic: Maximizing Survival by Establishing Triage Thresholds*

Supporting decision-making on allocation of ICU beds and ventilators in pandemics

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