title: The Development of an Evacuation Protocol for Patients with Ventricular Assist Devices During a Disaster.
abstract: Introduction Health care providers are on the forefront of delivering care and allocating resources during a disaster; however, very few are adequately trained to respond in these situations. Furthermore, there is a void in the literature regarding the specific care needs of patients with ventricular assist devices (VADs) in a disaster setting. This project aimed to develop an evidenced-based protocol to aid health care providers during the evacuation of patients with VADs during a disaster.
  
  
  METHODS
  This is a qualitative study that used expert review, tabletop discussion, and a survey of health care professionals to develop and evaluate an evacuation protocol. The protocol was revised after each stage of review in order to reach a consensus document.
  
  
  RESULTS
  The project concluded with the finalization of a protocol which addresses evacuation and patient triage, and also includes an algorithm to determine which staff members should be evacuated with patients, transportation resources, evacuation documentation, and items patients need during evacuation. The protocol also addressed steps to be taken in the event that evacuation efforts fail and how to manage outpatient VAD patients seeking assistance.
  
  
  CONCLUSIONS
  This protocol provides guidance for the care of VAD patients in the event of a disaster and evacuation. Protocols such as this address difficult scenarios and should be created prior to a disaster to assist staff in making difficult decisions. These documents should be created using multi-disciplinary feedback via the consensus model as well as the Institute of Medicine (IOM; National Academy of Medicine; Washington, DC USA) "Crisis Standards of Care." Davis KJ , Suyama J , Lingler J , Beach M . The development of an evacuation protocol for patients with ventricular assist devices during a disaster. Prehosp Disaster Med. 2017;32(3):333-338.
authors.affiliation: 1University of Pittsburgh Medical Center,Pittsburgh,PennsylvaniaUSA.
authors.forename: Katherine J
authors.initials: KJ
authors.lastname: Davis
authors.affiliation: 1University of Pittsburgh Medical Center,Pittsburgh,PennsylvaniaUSA.
authors.forename: Joseph
authors.initials: J
authors.lastname: Suyama
authors.affiliation: 2University of Pittsburgh School of Nursing,Pittsburgh,PennsylvaniaUSA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Lingler
authors.affiliation: 2University of Pittsburgh School of Nursing,Pittsburgh,PennsylvaniaUSA.
authors.forename: Michael
authors.initials: M
authors.lastname: Beach
mesh_terms: D004189:Disaster Planning; D006353:Heart-Assist Devices; D006801:Humans; D010414:Pennsylvania; D015397:Program Evaluation; D011795:Surveys and Questionnaires; D014218:Triage
keywords:  EMS Emergency Medical Services;  ICS incident command centers;  IOM Institute of Medicine;  NIMS National Incident Management System;  VAD ventricular assist device; disaster planning; preparedness; protocol; ventricular assist device