The American College of Chest Physicians releases new expert guidance in care of the critically ill and injured

August 21, 2014

The American College of Chest Physicians (CHEST) announces the immediate release of Care of the Critically Ill and Injured During Pandemics and Disasters: CHEST Consensus Statement today in the Online First section of the journal CHEST while the global health-care community cares for patients with the Ebola virus. The consensus statement aims to guide ethical decision-making, coordination of care, resource conservation, and research in crises. The statement was developed by over 100 clinicians and experts representing a broad variety and scope of clinical fields from more than nine countries. It offers the latest evidence-informed suggestions on how to best prepare and manage the critically ill and injured during large-scale disasters and pandemics.

"With the growing concern that the Ebola outbreak in West Africa may spread to other countries around the globe, CHEST has just released its timely and updated document for caring for the critically ill and injured during pandemics and disasters. The rigorously developed set of suggestions made by an unparalleled group of experts who comprise the CHEST Task Force for Mass Critical Care are intended to support bedside providers, hospital administrators, , and government planners," said Richard S. Irwin, MD, Master FCCP, Editor in Chief of the journal CHEST.

"We have worked to expedite the release of this document given the circumstances, particularly with regard to the resource-poor settings and ethical considerations associated with the current Ebola situation and hope that this might, in some way, aid those working so selflessly to control the epidemic and provide care for the victims of it," said Michael H. Baumann, MD, MS, FCCP, and President of CHEST.

The new statement also integrates suggestions and considerations for the management of children impacted by large-scale events because they represent at least a quarter of most nations' populations. The statement provides key suggestions on integration of hospitals with providers to expand bed capacity to maximally care for potentially large numbers of patients and to provide triage resources for patients under extreme shortages and also includes systems planning, business continuity, legal framework, provider education, and ethical considerations that facilitate the provision of this care. Suggestions are also provided for partnerships and improving capacity for disasters and pandemics in the developing world where resources are chronically depleted.

"In 2008, our task force gathered together to create the first version of our mass critical care . Following publication, the recommendations were employed during the 2009 H1N1 influenza pandemic in Mexico City, following the earthquake in Haiti and helped with triage during Hurricane Sandy," said Asha Devereaux, MD, MPH, FCCP, panel co-chair. "We have now provided an expanded scope in this new statement and feel the application of the document's recommendations will be even more useful for clinicians, institutions, and agencies throughout the world."

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