Article

Intensive Care Medicine

, Volume 36, Issue 1, pp 38-44

Chapter 5. Essential equipment, pharmaceuticals and supplies

  • Charles L. SprungAffiliated withDepartment of Anesthesiology and Critical Care Medicine, Hadassah Hebrew University Medical Center Email author 
  • , Jozef KeseciogluAffiliated withDepartment of Intensive Care Medicine, University Medical Center Utrecht

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Abstract

Purpose

To provide recommendations and standard operating procedures for intensive care unit and hospital preparations for an influenza pandemic or mass disaster with a specific focus on essential equipment, pharmaceuticals and supplies.

Methods

Based on a literature review and expert opinion, a Delphi process was used to define the essential topics including essential equipment, pharmaceuticals and supplies.

Results

Key recommendations include: (1) ensure that adequate essential medical equipment, pharmaceuticals and important supplies are available during a disaster; (2) develop a communication and coordination system between health care facilities and local/regional/state/country governmental authorities for the provision of additional support; (3) determine the required resources, order and stockpile adequate resources, and judiciously distribute them; (4) acquire additional mechanical ventilators that are portable, provide adequate gas exchange for a range of clinical conditions, function with low-flow oxygen and without high pressure, and are safe for patients and staff; (5) provide advanced ventilatory support and rescue therapies including high levels of inspired oxygen and positive end-expiratory pressure, volume and pressure control ventilation, inhaled nitric oxide, high-frequency ventilation, prone positioning ventilation and extracorporeal membrane oxygenation; (6) triage scarce resources including equipment, pharmaceuticals and supplies based on those who are likely to benefit most or on a ‘first come, first served’ basis.

Conclusions

Judicious planning and adoption of protocols for providing adequate equipment, pharmaceuticals and supplies are necessary to optimize outcomes during a pandemic.

Keywords

Equipment Pharmaceuticals Drugs Supplies Recommendations Standard operating procedures Intensive care unit Hospital H1N1 Influenza epidemic Pandemic Disaster