Disaster medicine and public health preparedness
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In a public health emergency, many more patients could require mechanical ventilators than can be accommodated. ⋯ New York State released the draft guidelines for public comment, allowing for revision to reflect both community values and medical innovation. This ventilator triage system represents a radical shift from ordinary standards of care, and may serve as a model for allocating other scarce resources in disasters.
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The ability to monitor assistance, define humanitarian needs, and approach equity in the distribution of assistance has lagged behind the world's growing commitment to responding to humanitarian emergencies. This article highlights relevant data sources to elucidate elements of an operational definition of humanitarian need. New and refined measures are proposed to assist in assessing the level of need among affected populations. An original measure that combines data on conflict and disasters to summarize the cumulative magnitude of 4 types of humanitarian threats is presented.
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Disaster Med Public Health Prep · Sep 2007
Is overtriage associated with increased mortality? Insights from a simulation model of mass casualty trauma care.
To examine the relationship between overtriage and critical mortality after a mass casualty incident (MCI) using a simulation model of trauma system response. ⋯ Increasing overtriage may have positive, negative, or mixed effects on critical mortality in this trauma system simulation model. These results, which contrast with prior analyses describing a positive linear relationship between overtriage and mortality, highlight the need for alternative metrics to describe trauma system response after MCIs. We explore using the relative number of critical patients to available and staffed treatment units, or the critical surge to capability ratio, which exhibits a consistent and nonlinear association with critical mortality in this model.