title: Definitive care for the critically ill during a disaster: medical resources for surge capacity: from a Task Force for Mass Critical Care summit meeting, January 26-27, 2007, Chicago, IL.
abstract: BACKGROUND
  Mass numbers of critically ill disaster victims will stress the abilities of health-care systems to maintain usual critical care services for all in need. To enhance the number of patients who can receive life-sustaining interventions, the Task Force on Mass Critical Care (hereafter termed the Task Force) has suggested a framework for providing limited, essential critical care, termed emergency mass critical care (EMCC). This article suggests medical equipment, concepts to expand treatment spaces, and staffing models for EMCC.
  
  
  METHODS
  Consensus suggestions for EMCC were derived from published clinical practice guidelines and medical resource utilization data for the everyday critical care conditions that are anticipated to predominate during mass critical care events. When necessary, expert opinion was used. TASK FORCE MAJOR SUGGESTIONS: The Task Force makes the following suggestions: (1) one mechanical ventilator that meets specific characteristics, as well as a set of consumable and durable medical equipment, should be provided for each EMCC patient; (2) EMCC should be provided in hospitals or similarly equipped structures; after ICUs, postanesthesia care units, and emergency departments all reach capacity, hospital locations should be repurposed for EMCC in the following order: (A) step-down units and large procedure suites, (B) telemetry units, and (C) hospital wards; and (3) hospitals can extend the provision of critical care using non-critical care personnel via a deliberate model of delegation to match staff competencies with patient needs.
  
  
  CONCLUSIONS
  By using the Task Force suggestions for adequate supplies of medical equipment, appropriate treatment space, and trained staff, communities may better prepare to deliver augmented essential critical care in response to disasters.
authors.affiliation: University of Washington, Harborview Medical Center, Campus Box 359762, 325 Ninth Ave, Seattle, WA 98104, USA. rubinson@u.washington.edu
authors.forename: Lewis
authors.initials: L
authors.lastname: Rubinson
authors.forename: John L
authors.initials: JL
authors.lastname: Hick
authors.forename: J Randall
authors.initials: JR
authors.lastname: Curtis
authors.forename: Richard D
authors.initials: RD
authors.lastname: Branson
authors.forename: Suzi
authors.initials: S
authors.lastname: Burns
authors.forename: Michael D
authors.initials: MD
authors.lastname: Christian
authors.forename: Asha V
authors.initials: AV
authors.lastname: Devereaux
authors.forename: Jeffrey R
authors.initials: JR
authors.lastname: Dichter
authors.forename: Daniel
authors.initials: D
authors.lastname: Talmor
authors.forename: Brian
authors.initials: B
authors.lastname: Erstad
authors.forename: Justine
authors.initials: J
authors.lastname: Medina
authors.forename: James A
authors.initials: JA
authors.lastname: Geiling
mesh_terms: D003422:Critical Care / Q000458:organization & administration*; D006295:Health Resources / Q000458:organization & administration*; D006801:Humans; D054527:Mass Casualty Incidents; D014481:United States; D012122:Ventilators, Mechanical / Q000600:supply & distribution*; D000078329:Workforce