title: Chapter 5. Essential equipment, pharmaceuticals and supplies. Recommendations and standard operating procedures for intensive care unit and hospital preparations for an influenza epidemic or mass disaster.
abstract: OBJECTIVE
  To provide recommendations and standard operating procedures for intensive care unit and hospital preparations for an influenza pandemic or mass disaster with a specific focus on essential equipment, pharmaceuticals and supplies.
  
  
  METHODS
  Based on a literature review and expert opinion, a Delphi process was used to define the essential topics including essential equipment, pharmaceuticals and supplies.
  
  
  RESULTS
  Key recommendations include: (1) ensure that adequate essential medical equipment, pharmaceuticals and important supplies are available during a disaster; (2) develop a communication and coordination system between health care facilities and local/regional/state/country governmental authorities for the provision of additional support; (3) determine the required resources, order and stockpile adequate resources, and judiciously distribute them; (4) acquire additional mechanical ventilators that are portable, provide adequate gas exchange for a range of clinical conditions, function with low-flow oxygen and without high pressure, and are safe for patients and staff; (5) provide advanced ventilatory support and rescue therapies including high levels of inspired oxygen and positive end-expiratory pressure, volume and pressure control ventilation, inhaled nitric oxide, high-frequency ventilation, prone positioning ventilation and extracorporeal membrane oxygenation; (6) triage scarce resources including equipment, pharmaceuticals and supplies based on those who are likely to benefit most or on a 'first come, first served' basis.
  
  
  CONCLUSIONS
  Judicious planning and adoption of protocols for providing adequate equipment, pharmaceuticals and supplies are necessary to optimize outcomes during a pandemic.
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, Hadassah Hebrew University Medical Center, Jerusalem, Israel. charles.sprung@ekmd.huji.ac.il
authors.forename: Charles L
authors.initials: CL
authors.lastname: Sprung
authors.forename: Jozef
authors.initials: J
authors.lastname: Kesecioglu
mesh_terms: D004189:Disaster Planning; D004196:Disease Outbreaks; D004865:Equipment and Supplies, Hospital / Q000592:standards* / Q000600:supply & distribution; D006739:Hospital Administration; D006747:Hospital Communication Systems; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype; D007251:Influenza, Human / Q000453:epidemiology* / Q000628:therapy* / Q000821:virology; D007318:Inservice Training / Q000379:methods; D007373:Interinstitutional Relations; D054527:Mass Casualty Incidents; D020380:Needs Assessment; D010360:Patient Transfer / Q000592:standards; D010607:Pharmacy Service, Hospital / Q000458:organization & administration / Q000592:standards*; D012040:Regional Health Planning / Q000379:methods / Q000458:organization & administration / Q000592:standards; D055872:Surge Capacity; D000078329:Workforce