Pandemic preparedness.
OBJECTIVE
Pandemic influenza remains a threat to world health and will probably result in an overwhelming number of critically ill patients. Preparations should be made now to meet this threat.


RESULTS
Limited data are available on which to base preparations. Adequate staffing is crucial to the functioning of an ICU and therefore occupational safety is of central concern. In the absence of knowledge of the method of spread of a pandemic disease, it would seem appropriate to take airborne and contact precautions, and the literature related to this area is reviewed. Methods of recruiting and training additional staff and the issues of bed capacity, stockpiling, triage and ethics are discussed.


CONCLUSIONS
Extensive preparation is needed in advance of an epidemic. This should include occupational safety measures, stockpiling of equipment and drugs, staff training, development of triage policies, and discussion of the limits of duty of care to patients. These preparations take considerable time and therefore these issues should be tackled urgently.
Gomersall
Charles D
CD
Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong. gomersall@cuhk.edu.hk
Loo
Shi
S
Joynt
Gavin M
GM
Taylor
Bruce L
BL
D016638:Critical Illness; D004189:Disaster Planning; D004190:Disasters; D004196:Disease Outbreaks / Q000517:prevention & control*; D004992:Ethics, Medical; D014943:Global Health; D006742:Hospital Bed Capacity; D006801:Humans; D007251:Influenza, Human / Q000517:prevention & control*; D007362:Intensive Care Units; D016272:Occupational Health; D014218:Triage