TY - JOUR
T1 - A multicentre evaluation of two intensive care unit triage protocols for use in an influenza pandemic
AU - Cheung, Winston K.
AU - Myburgh, John
AU - Seppelt, Ian M.
AU - Parr, Michael J.
AU - Blackwell, Nikki
AU - DeMonte, Shannon
AU - Gandhi, Kalpesh
AU - Hoyling, Larissa
AU - Nair, Priya
AU - Passer, Melissa
AU - Reynolds, Claire
AU - Saunders, Nicholas M.
AU - Saxena, Manoj K.
AU - Thanakrishnan, Govindasamy
PY - 2012/8
Y1 - 2012/8
N2 - 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. Design, setting and patients: 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. Main outcome measure: 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). Conclusion: 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.
AB - 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. Design, setting and patients: 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. Main outcome measure: 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). Conclusion: 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.
UR - http://www.scopus.com/inward/record.url?scp=84867357498&partnerID=8YFLogxK
U2 - 10.5694/mja11.10926
DO - 10.5694/mja11.10926
M3 - Article
C2 - 22860797
AN - SCOPUS:84867357498
SN - 0025-729X
VL - 197
SP - 178
EP - 181
JO - Medical Journal of Australia
JF - Medical Journal of Australia
IS - 3
ER -