Disaster Planning for the Intensive Care Unit: A Critical Framework
Safe and efficient delivery of critical care during disasters is a complex endeavor that requires meticulous planning. Development of an initial plan should take an “all-hazards” approach, building a basic plan that covers all disaster types. Planners can then use a hazard-vulnerability analysis (HVA) to focus more specific planning on those disaster types for which a given health system, hospital, or intensive care unit is at greatest risk. Plans should incorporate three equally important areas: the availability and use of physical space, hospital resources (supplies and equipment) both on site and readily available, and staffing concerns. Potential need for evacuation should also be addressed. Horizontal (within hospital) and vertical (complete) evacuation planning should also be undertaken. Finally, disaster plans should include guidance for the allocation of scarce healthcare resources if all surge capacity is exhausted and evacuation is not possible. Scarce resource allocation planning is essential to maximizing the likelihood that limited resources will be distributed in a fair and transparent way during a crisis. Disasters create a myriad of challenges for healthcare delivery. Careful planning can mitigate the potential harms to patients in such situations and provide a structure for delivering safe, efficient care in spite of those challenges.
KeywordsIntensive care unit Disaster planning All-hazards planning Hazard vulnerability Evacuation
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