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.
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.
Sprung
Charles L
CL
Department of Anesthesiology and Critical Care Medicine, Hadassah Hebrew University Medical Center, Jerusalem, Israel. charles.sprung@ekmd.huji.ac.il
Kesecioglu
Jozef
J
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