title: Resource-poor settings: response, recovery, and research: care of the critically ill and injured during pandemics and disasters: CHEST consensus statement.
abstract: BACKGROUND
  Planning for mass critical care in resource-poor and constrained settings has been largely ignored, despite large, densely crowded populations who are prone to suffer disproportionately from natural disasters. As a result, disaster response has been suboptimal and in many instances hampered by lack of planning, education and training, information, and communication.
  
  
  METHODS
  The Resource-Poor Settings panel developed five key question domains; defining the term resource poor and using the traditional phases of the disaster cycle (mitigation/preparedness/response/recovery). Literature searches were conducted to identify evidence to answer the key questions in these areas. Given a lack of data on which to develop evidence-based recommendations, expert-opinion suggestions were developed, and consensus was achieved using a modified Delphi process.
  
  
  RESULTS
  The five key questions were as follows: definition, capacity building and mitigation, what resources can we bring to bear to assist/surge, response, and reconstitution and recovery of host nation critical care capabilities. Addressing these led the panel to offer 33 suggestions. Because of the large number of suggestions, the results have been separated into two sections: part I, Infrastructure/Capacity in the accompanying article, and part II, Response/Recovery/Research in this article.
  
  
  CONCLUSIONS
  A lack of rudimentary ICU resources and capacity to enhance services plagues resource-poor or constrained settings. Capacity building therefore entails preventative strategies and strengthening of primary health services. Assistance from other countries and organizations is often needed to mount a surge response. Moreover, the disengagement of these responding groups and host country recovery require active planning. Future improvements in all phases require active research activities.
authors.forename: James
authors.initials: J
authors.lastname: Geiling
authors.forename: Frederick M
authors.initials: FM
authors.lastname: Burkle
authors.forename: T Eoin
authors.initials: TE
authors.lastname: West
authors.forename: Timothy M
authors.initials: TM
authors.lastname: Uyeki
authors.forename: Dennis
authors.initials: D
authors.lastname: Amundson
authors.forename: Guillermo
authors.initials: G
authors.lastname: Dominguez-Cherit
authors.forename: Charles D
authors.initials: CD
authors.lastname: Gomersall
authors.forename: Matthew L
authors.initials: ML
authors.lastname: Lim
authors.forename: Valerie
authors.initials: V
authors.lastname: Luyckx
authors.forename: Babak
authors.initials: B
authors.lastname: Sarani
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: Niranjan
authors.initials: N
authors.lastname: Kissoon
mesh_terms: D032921:Consensus; D003422:Critical Care / Q000592:standards; D016638:Critical Illness / Q000628:therapy*; D004190:Disasters; D006295:Health Resources / Q000458:organization & administration*; D006801:Humans; D058873:Pandemics; D012106:Research / Q000458:organization & administration*; D014947:Wounds and Injuries / Q000628:therapy*