title: A multicentre evaluation of two intensive care unit triage protocols for use in an influenza pandemic.
abstract: OBJECTIVE
  To determine the increase in intensive care unit (ICU) bed availability that would result from the use of the New South Wales and Ontario Health Plan for an Influenza Pandemic (OHPIP) triage protocols.
  
  
  METHODS
  Prospective evaluation study conducted in eight Australian, adult, general ICUs, between September 2009 and May 2010. All patients who were admitted to the ICU, excluding those who had elective surgery, were prospectively evaluated using the two triage protocols, simulating a pandemic situation. Both protocols were originally developed to determine which patients should be excluded from accessing ICU resources during an influenza pandemic.
  
  
  METHODS
  Increase in ICU bed availability.
  
  
  RESULTS
  At admission, the increases in ICU bed availability using Tiers 1, 2 and 3 of the NSW triage protocol were 3.5%, 14.7% and 22.7%, respectively, and 52.8% using the OHPIP triage protocol (P < 0.001). Re-evaluation of patients at 12 hours after admission using Tiers 1, 2 and 3 of the NSW triage protocol incrementally increased ICU bed availability by 19.2%, 16.1% and 14.1%, respectively (P < 0.001). The maximal cumulative increases in ICU bed availability using Tiers 1, 2 and 3 of the NSW triage protocol were 23.7%, 31.6% and 37.5%, respectively, at 72 hours (P < 0.001), and 65.0% using the OHPIP triage protocol, at 120 hours (P < 0.001).
  
  
  CONCLUSIONS
  Both triage protocols resulted in increases in ICU bed availability, but the OHPIP protocol provided the greatest increase overall. With the NSW triage protocol, ICU bed availability increased as the protocol was escalated.
authors.affiliation: Concord Repatriation General Hospital, Sydney, NSW. winston.cheung@sswahs.nsw.gov.au
authors.forename: Winston K
authors.initials: WK
authors.lastname: Cheung
authors.forename: John
authors.initials: J
authors.lastname: Myburgh
authors.forename: Ian M
authors.initials: IM
authors.lastname: Seppelt
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Parr
authors.forename: Nikki
authors.initials: N
authors.lastname: Blackwell
authors.forename: Shannon
authors.initials: S
authors.lastname: Demonte
authors.forename: Kalpesh
authors.initials: K
authors.lastname: Gandhi
authors.forename: Larissa
authors.initials: L
authors.lastname: Hoyling
authors.forename: Priya
authors.initials: P
authors.lastname: Nair
authors.forename: Melissa
authors.initials: M
authors.lastname: Passer
authors.forename: Claire
authors.initials: C
authors.lastname: Reynolds
authors.forename: Nicholas M
authors.initials: NM
authors.lastname: Saunders
authors.forename: Manoj K
authors.initials: MK
authors.lastname: Saxena
authors.forename: Govindasamy
authors.initials: G
authors.lastname: Thanakrishnan
mesh_terms: D001315:Australia / Q000453:epidemiology; D002985:Clinical Protocols; D005260:Female; D006801:Humans; D066298:In Vitro Techniques; D007251:Influenza, Human / Q000453:epidemiology / Q000628:therapy*; D007362:Intensive Care Units / Q000458:organization & administration* / Q000600:supply & distribution; D008875:Middle Aged; D058873:Pandemics; D011446:Prospective Studies; D014218:Triage / Q000379:methods*