2019
DOI: 10.7196/sajcc.2019.v35i1b.380
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The Critical Care Society of Southern Africa Consensus Guideline on ICU Triage and Rationing (ConICTri)

Abstract: Background. In South Africa (SA), administrators and intensive care practitioners are faced with the challenge of resource scarcity as well as an increasing demand for intensive care unit (ICU) services. ICU services are expensive, and practitioners in low-to middleincome countries experience the consequences of limited resources daily. Critically limited resources necessitate that rationing and triage (prioritisation) decisions are routinely necessary in SA, particularly in the publicly funded health sector. … Show more

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Cited by 9 publications
(21 citation statements)
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“…The provision of dialysis is also government-funded and not restricted within the ICU or by HIV status. However, general prognosis and current resource limitations are taken into consideration prior to the admission of any patient to the ICU [22]. The modality of dialysis is chosen by the treating consultant based on clinical status with a preference for intermittent haemodialysis or sustained low efficiency daily dialysis (SLEDD) due to cost constraints.…”
Section: Methodsmentioning
confidence: 99%
“…The provision of dialysis is also government-funded and not restricted within the ICU or by HIV status. However, general prognosis and current resource limitations are taken into consideration prior to the admission of any patient to the ICU [22]. The modality of dialysis is chosen by the treating consultant based on clinical status with a preference for intermittent haemodialysis or sustained low efficiency daily dialysis (SLEDD) due to cost constraints.…”
Section: Methodsmentioning
confidence: 99%
“…A similar approach has been adopted in numerous subsequent guidelines and resource allocation frameworks. 2,11,[21][22][23][24] Therefore, because of ease of implementation and broad acceptance in the literature, we chose the OHPIP as a starting point.…”
Section: How Was Saskatchewan's Critical Care Resource Allocation Framentioning
confidence: 99%
“…developed and published in 2019 to inform day-to day triage and ICU rationing as well as to guide administrators and inform the public about appropriate triage decision-making. [8] In routine circumstances, ICU triage is premised on the best interests of an individual patient, including the likelihood of benefit from ICU treatment v. the potential for more harm when invasive ICU treatment is provided. Intensive care management is certainly not always in a patient's best interests.…”
Section: In Practicementioning
confidence: 99%
“…This balancing speaks to the ethical principles of beneficence (doing good) and nonmaleficence (avoiding harm), which are among the fundamental ethical considerations for triage decisions. [8] For example, many patients with incurable life-limiting conditions would benefit far more from a palliative care approach, aimed at managing distressing symptoms and maintaining an acceptable quality of life. Providing a scarce resource such as ICU care to patients who are unlikely to benefit in the short or longer term prevents this care being given to those who have a good chance of benefiting.…”
Section: In Practicementioning
confidence: 99%