Intensive Care Medicine

, Volume 36, Supplement 1, pp 38–44 | Cite as

Chapter 5. Essential equipment, pharmaceuticals and supplies

Article

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 

Notes

Conflict of interest

None.

References

  1. 1.
    Beigel JH, Farrar J, Han AM et al (2005) Avian influenza A (H5N1) infection in humans. N Engl J Med 353:1374–1385CrossRefPubMedGoogle Scholar
  2. 2.
    The ANZIC Influenza Investigators (2009) Critical Care Services and 2009 H1N1 Influenza in Australia and New Zealand. N Engl J Med 361:1925–1934CrossRefGoogle Scholar
  3. 3.
    Osterholm MT (2005) Preparing for the next pandemic. N Engl J Med 352:1839–1842CrossRefPubMedGoogle Scholar
  4. 4.
    Rubinson L, Nuzzo JB, Talmor DS, O’Toole T, Kramer BR, Inglesby TV (2005) Augmentation of hospital critical care capacity after bioterrorist attacks or epidemics: recommendations of the Working Group on Emergency Mass Critical Care. Crit Care Med 33:E2393–E2403CrossRefGoogle Scholar
  5. 5.
    Rubinson L, Hick JL, Curtis JR et al (2008) Task Force for Mass Critical Care. Definitive care for the critically ill during a disaster: medical resources for surge capacity: from a Task Force for Mass Critical Care summit meeting, January 26–27, 2007, Chicago, IL. Chest 133(Suppl 5):32S–50SCrossRefPubMedGoogle Scholar
  6. 6.
    Devereaux AV, Dichter JR, Christian MD et al (2008) Definitive care for the critically ill during a disaster: a framework for allocation of scarce resources in mass critical care: from a Task Force for Mass Critical Care summit meeting, January 26–27, 2007, Chicago, IL. Chest 133(Suppl 5):51S–66SCrossRefPubMedGoogle Scholar
  7. 7.
    Simchen E, Sprung CL, Galai N et al (2004) Survival of critically ill patients hospitalized in and out of intensive care units under paucity of intensive care unit beds. Crit Care Med 32:1654–1661CrossRefPubMedGoogle Scholar
  8. 8.
    Devereaux AV, Christian MD, Dichter JR et al (2008) Summary of suggestions from the Task Force for Mass Critical Care summit meeting, January 26–27, 2007, Chicago, IL. Chest 133(Suppl 5):1S–7SCrossRefPubMedGoogle Scholar
  9. 9.
    Pan American Health Organization and World Health Organization (2009) Considerations and interim recommendations for the clinical management of human infection with the pandemic influenza (H1N1) 2009 virus. PAHO/WHO expert consultationGoogle Scholar
  10. 10.
    Domınguez-Cherit G, Lapinsky SE, Macias AE et al (2009) Critically ill patients with 2009 influenza A(H1N1) in Mexico. JAMA 302(17):1880–1887Google Scholar
  11. 11.
    Kumar A, Zarychanski R, Pinto R et al (2009) Canadian Critical Care Trials Group H1N1 Collaborative. Critically ill patients with 2009 influenza A(H1N1) infection in Canada. JAMA 302(17):1872–1879Google Scholar
  12. 12.
    Rello J, Rodriguez A, Ibanez P et al (2009) Intensive care adult patients with severe respiratory failure caused by Influenza A (H1N1) in Spain. Crit Care 13:R148. doi: 10.1186/cc8044 CrossRefPubMedGoogle Scholar
  13. 13.
    The Australia and New Zealand Extracorporeal Membrane Oxygenation (ANZ ECMO) Influenza Investigators (2009) Extracorporeal membrane oxygenation for 2009 influenza A(H1N1) acute respiratory distress syndrome. JAMA. doi: 10.1001/jama.2009.1535
  14. 14.
    Hick JL, O’Laughlin DT (2006) Concept of operations for triage of mechanical ventilation in an epidemic. Acad Emerg Med 13:223–229CrossRefPubMedGoogle Scholar
  15. 15.
    Birnkrant D, Cox E (2009) The emergency use authorization of peramivir for treatment of 2009 H1N1 influenza. N Engl J Med 361:2204–2207CrossRefPubMedGoogle Scholar
  16. 16.
    The Society of Critical Care Medicine Ethics Committee (1994) Consensus statement on the triage of critically ill patients. JAMA 271:1200–1203CrossRefGoogle Scholar
  17. 17.
    American Thoracic Society Bioethics Task Force (1997) Fair Allocation of Intensive Care Unit Resources. Am J Respir Crit Care Med 156:1282–1301Google Scholar
  18. 18.
    Echevarría-Zuno S, Mejía-Aranguré JM, Mar-Obeso AJ et al (2009) Infection and death from influenza A H1N1 virus in Mexico: a retrospective analysis. Lancet 374:2072–2079Google Scholar
  19. 19.
    White DB, Angus DC (2009) Preparing for the sickest patients with 2009 influenza A (H1N1). JAMA. doi: 10.1001/jama.2009.1539

Copyright information

© Copyright jointly hold by Springer and ESICM 2010

Authors and Affiliations

  1. 1.Department of Anesthesiology and Critical Care MedicineHadassah Hebrew University Medical CenterJerusalemIsrael
  2. 2.Department of Intensive Care MedicineUniversity Medical Center UtrechtUtrechtThe Netherlands

Personalised recommendations