title: Resource-poor settings: infrastructure and capacity building: care of the critically ill and injured during pandemics and disasters: CHEST consensus statement.
abstract: BACKGROUND
  Planning for mass critical care (MCC) in resource-poor or constrained settings has been largely ignored, despite their large populations that are prone to suffer disproportionately from natural disasters. Addressing MCC in these settings has the potential to help vast numbers of people and also to inform planning for better-resourced areas.
  
  
  METHODS
  The Resource-Poor Settings panel developed five key question domains; defining the term resource poor and using the traditional phases of disaster (mitigation/preparedness/response/recovery), literature searches were conducted to identify evidence on which to answer the key questions in these areas. Given a lack of data upon 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 then separated as follows: definition, infrastructure and capacity building, resources, response, and reconstitution/recovery of host nation critical care capabilities and research. Addressing these questions led the panel to offer 33 suggestions. Because of the large number of suggestions, the results have been separated into two sections: part 1, Infrastructure/Capacity in this article, and part 2, Response/Recovery/Research in the accompanying article.
  
  
  CONCLUSIONS
  Lack of, or presence of, rudimentary ICU resources and limited capacity to enhance services further challenge resource-poor and constrained settings. Hence, capacity building entails preventative strategies and strengthening of primary health services. Assistance from other countries and organizations is needed to mount a surge response. Moreover, planning should include when to disengage and how the host nation can provide capacity beyond the mass casualty care event.
authors.forename: James
authors.initials: J
authors.lastname: Geiling
authors.forename: Frederick M
authors.initials: FM
authors.lastname: Burkle
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: Timothy M
authors.initials: TM
authors.lastname: Uyeki
authors.forename: T Eoin
authors.initials: TE
authors.lastname: West
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: D057191:Capacity Building / Q000458:organization & administration*; D032921:Consensus; D003422:Critical Care / Q000458:organization & administration*; D016638:Critical Illness / Q000628:therapy*; D006295:Health Resources / Q000458:organization & administration*; D006801:Humans; D058873:Pandemics; D014947:Wounds and Injuries / Q000628:therapy*