Disaster Triage: who gets what?

Sara Gray

Guidingprinciples

Inclusion & exclusion criteria

Defined process

Guidingprinciples

Inclusion & exclusion criteria

Defined process

Inclusion Criteria

1. Mechanical ventilation2. Vasopressors

Exclusi

on Criteria

1. Cardiac arrest2. Severe trauma3. Severe burns4. Metastatic malignancy5. DNR6. Severe end organ failure

End organ failure = excluded?• NYHA III/IV• FEV1 < 25%• MELD > 20• Severe dementia• Severe irreversible neuro condition• Severe irreversible immunocompromise

Guidingprinciples

Inclusion & exclusion criteria

Defined process

Triage of Scarce ResourcesMitigate

Utilitarian ethicsClear activation triggers

Broad buy-in and engagementDedicated team

Fair process

This discussion is worth it, if it saves more lives.

www.saragray.org @EmICUcanada