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The following results are related to COVID-19. Are you interested to view more results? Visit OpenAIRE - Explore.
31 Research products, page 1 of 4

  • COVID-19
  • Publications
  • Open Access
  • CA
  • CHEST Journal
  • COVID-19

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  • Publication . Article . 2020
    Open Access English
    Authors: 
    Nisha Andany; Nick Daneman;
    Publisher: American College of Chest Physicians. Published by Elsevier Inc.
  • Open Access
    Authors: 
    Valerie G. Press; Andrea S. Gershon; Frank C. Sciurba; Denitza P. Blagev;
    Publisher: Elsevier BV
  • Publication . Article . 2014
    Open Access
    Authors: 
    Asha V. Devereaux; Pritish K. Tosh; John L. Hick; Dan Hanfling; James A. Geiling; Mary Jane Reed; Timothy M. Uyeki; Umair A. Shah; Daniel B. Fagbuyi; Peter Skippen; +4 more
    Publisher: Elsevier BV

    BACKGROUND Engagement and education of ICU clinicians in disaster preparedness is fragmented by time constraints and institutional barriers and frequently occurs during a disaster. We reviewed the existing literature from 2007 to April 2013 and expert opinions about clinician engagement and education for critical care during a pandemic or disaster and offer suggestions for integrating ICU clinicians into planning and response. The suggestions in this article are important for all of those involved in a pandemic or large-scale disaster with multiple critically ill or injured patients, including front-line clinicians, hospital administrators, and public health or government officials. METHODS A systematic literature review was performed and suggestions formulated according to the American College of Chest Physicians (CHEST) Consensus Statement development methodology. We assessed articles, documents, reports, and gray literature reported since 2007. Following expert-informed sorting and review of the literature, key priority areas and questions were developed. No studies of sufficient quality were identified upon which to make evidence-based recommendations. Therefore, the panel developed expert opinion-based suggestions using a modified Delphi process. RESULTS Twenty-three suggestions were formulated based on literature-informed consensus opinion. These suggestions are grouped according to the following thematic elements: (1) situational awareness, (2) clinician roles and responsibilities, (3) education, and (4) community engagement. Together, these four elements are considered to form the basis for effective ICU clinician engagement for mass critical care. CONCLUSIONS The optimal engagement of the ICU clinical team in caring for large numbers of critically ill patients due to a pandemic or disaster will require a departure from the routine independent systems operating in hospitals. An effective response will require robust information systems; coordination among clinicians, hospitals, and governmental organizations; pre-event engagement of relevant stakeholders; and standardized core competencies for the education and training of critical care clinicians.

  • Publication . Article . 2020
    Open Access
    Authors: 
    Lisa Burry; Jeffrey F. Barletta; David Williamson; Salmaan Kanji; Ryan C. Maves; Jeffrey R. Dichter; Michael D. Christian; James A. Geiling; Brian L. Erstad;
    Publisher: Elsevier BV

    Critical drug shortages have been widely documented during the coronavirus disease 2019 (COVID-19) pandemic, particularly for IV sedatives used to facilitate mechanical ventilation. Surges in volume of patients requiring mechanical ventilation coupled with prolonged ventilator days and the high sedative dosing requirements observed quickly led to the depletion of "just-in-time" inventories typically maintained by institutions. This manuscript describes drug shortages in the context of global, manufacturing, regional and institutional perspectives in times of a worldwide crisis such as a pandemic. We describe etiologic factors that lead to drug shortages including issues related to supply (eg, manufacturing difficulties, supply chain breakdowns) and variables that influence demand (eg, volatile prescribing practices, anecdotal or low-level data, hoarding). In addition, we describe methods to mitigate drug shortages as well as conservation strategies for sedatives, analgesics and neuromuscular blockers that could readily be applied at the bedside. The COVID-19 pandemic has accentuated the need for a coordinated, multi-pronged approach to optimize medication availability as individual or unilateral efforts are unlikely to be successful.

  • Open Access English
    Authors: 
    Marco Confalonieri; Francesco Salton; Paola Confalonieri; Bram Rochwerg; G. Umberto Meduri;
    Publisher: American College of Chest Physicians. Published by Elsevier Inc.
  • Publication . Article . 2021
    Open Access
    Authors: 
    Gianfranco Umberto Meduri; Bram Rochwerg;
    Publisher: Elsevier BV
  • Open Access
    Authors: 
    Mohit Sodhi; Mahyar Etminan;
    Publisher: Elsevier BV
  • Open Access English
    Authors: 
    Najib T. Ayas; Kristin Fraser; Eleni Giannouli; Patrick J. Hanly; Tetyana Kendzerska; Sherri L. Katz; Brandy N. Lachmann; Annie C. Lajoie; Caroline Minville; Debra Morrison; +4 more
    Publisher: Elsevier BV
    Project: CIHR
  • Open Access
    Authors: 
    Ryan C. Maves; James Downar; Jeffrey R. Dichter; John L. Hick; Asha V. Devereaux; James A. Geiling; Niranjan Kissoon; Nathaniel Hupert; Alexander S. Niven; Mary A. King; +13 more
    Publisher: Elsevier BV

    Public health emergencies have the potential to place enormous strain on health systems. The current pandemic of the novel 2019 coronavirus disease has required hospitals in numerous countries to expand their surge capacity to meet the needs of patients with critical illness. When even surge capacity is exceeded, however, principles of critical care triage may be needed as a means to allocate scarce resources, such as mechanical ventilators or key medications. The goal of a triage system is to direct limited resources towards patients most likely to benefit from them. Implementing a triage system requires careful coordination between clinicians, health systems, local and regional governments, and the public, with a goal of transparency to maintain trust. We discuss the principles of tertiary triage and methods for implementing such a system, emphasizing that these systems should serve only as a last resort. Even under triage, we must uphold our obligation to care for all patients as best possible under difficult circumstances.

  • Publication . Article . 2021
    Open Access
    Authors: 
    Kirsten M. Fiest; Karla D. Krewulak;
    Publisher: Elsevier BV
Advanced search in Research products
Research products
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Searching FieldsTerms
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The following results are related to COVID-19. Are you interested to view more results? Visit OpenAIRE - Explore.
31 Research products, page 1 of 4
  • Publication . Article . 2020
    Open Access English
    Authors: 
    Nisha Andany; Nick Daneman;
    Publisher: American College of Chest Physicians. Published by Elsevier Inc.
  • Open Access
    Authors: 
    Valerie G. Press; Andrea S. Gershon; Frank C. Sciurba; Denitza P. Blagev;
    Publisher: Elsevier BV
  • Publication . Article . 2014
    Open Access
    Authors: 
    Asha V. Devereaux; Pritish K. Tosh; John L. Hick; Dan Hanfling; James A. Geiling; Mary Jane Reed; Timothy M. Uyeki; Umair A. Shah; Daniel B. Fagbuyi; Peter Skippen; +4 more
    Publisher: Elsevier BV

    BACKGROUND Engagement and education of ICU clinicians in disaster preparedness is fragmented by time constraints and institutional barriers and frequently occurs during a disaster. We reviewed the existing literature from 2007 to April 2013 and expert opinions about clinician engagement and education for critical care during a pandemic or disaster and offer suggestions for integrating ICU clinicians into planning and response. The suggestions in this article are important for all of those involved in a pandemic or large-scale disaster with multiple critically ill or injured patients, including front-line clinicians, hospital administrators, and public health or government officials. METHODS A systematic literature review was performed and suggestions formulated according to the American College of Chest Physicians (CHEST) Consensus Statement development methodology. We assessed articles, documents, reports, and gray literature reported since 2007. Following expert-informed sorting and review of the literature, key priority areas and questions were developed. No studies of sufficient quality were identified upon which to make evidence-based recommendations. Therefore, the panel developed expert opinion-based suggestions using a modified Delphi process. RESULTS Twenty-three suggestions were formulated based on literature-informed consensus opinion. These suggestions are grouped according to the following thematic elements: (1) situational awareness, (2) clinician roles and responsibilities, (3) education, and (4) community engagement. Together, these four elements are considered to form the basis for effective ICU clinician engagement for mass critical care. CONCLUSIONS The optimal engagement of the ICU clinical team in caring for large numbers of critically ill patients due to a pandemic or disaster will require a departure from the routine independent systems operating in hospitals. An effective response will require robust information systems; coordination among clinicians, hospitals, and governmental organizations; pre-event engagement of relevant stakeholders; and standardized core competencies for the education and training of critical care clinicians.

  • Publication . Article . 2020
    Open Access
    Authors: 
    Lisa Burry; Jeffrey F. Barletta; David Williamson; Salmaan Kanji; Ryan C. Maves; Jeffrey R. Dichter; Michael D. Christian; James A. Geiling; Brian L. Erstad;
    Publisher: Elsevier BV

    Critical drug shortages have been widely documented during the coronavirus disease 2019 (COVID-19) pandemic, particularly for IV sedatives used to facilitate mechanical ventilation. Surges in volume of patients requiring mechanical ventilation coupled with prolonged ventilator days and the high sedative dosing requirements observed quickly led to the depletion of "just-in-time" inventories typically maintained by institutions. This manuscript describes drug shortages in the context of global, manufacturing, regional and institutional perspectives in times of a worldwide crisis such as a pandemic. We describe etiologic factors that lead to drug shortages including issues related to supply (eg, manufacturing difficulties, supply chain breakdowns) and variables that influence demand (eg, volatile prescribing practices, anecdotal or low-level data, hoarding). In addition, we describe methods to mitigate drug shortages as well as conservation strategies for sedatives, analgesics and neuromuscular blockers that could readily be applied at the bedside. The COVID-19 pandemic has accentuated the need for a coordinated, multi-pronged approach to optimize medication availability as individual or unilateral efforts are unlikely to be successful.

  • Open Access English
    Authors: 
    Marco Confalonieri; Francesco Salton; Paola Confalonieri; Bram Rochwerg; G. Umberto Meduri;
    Publisher: American College of Chest Physicians. Published by Elsevier Inc.
  • Publication . Article . 2021
    Open Access
    Authors: 
    Gianfranco Umberto Meduri; Bram Rochwerg;
    Publisher: Elsevier BV
  • Open Access
    Authors: 
    Mohit Sodhi; Mahyar Etminan;
    Publisher: Elsevier BV
  • Open Access English
    Authors: 
    Najib T. Ayas; Kristin Fraser; Eleni Giannouli; Patrick J. Hanly; Tetyana Kendzerska; Sherri L. Katz; Brandy N. Lachmann; Annie C. Lajoie; Caroline Minville; Debra Morrison; +4 more
    Publisher: Elsevier BV
    Project: CIHR
  • Open Access
    Authors: 
    Ryan C. Maves; James Downar; Jeffrey R. Dichter; John L. Hick; Asha V. Devereaux; James A. Geiling; Niranjan Kissoon; Nathaniel Hupert; Alexander S. Niven; Mary A. King; +13 more
    Publisher: Elsevier BV

    Public health emergencies have the potential to place enormous strain on health systems. The current pandemic of the novel 2019 coronavirus disease has required hospitals in numerous countries to expand their surge capacity to meet the needs of patients with critical illness. When even surge capacity is exceeded, however, principles of critical care triage may be needed as a means to allocate scarce resources, such as mechanical ventilators or key medications. The goal of a triage system is to direct limited resources towards patients most likely to benefit from them. Implementing a triage system requires careful coordination between clinicians, health systems, local and regional governments, and the public, with a goal of transparency to maintain trust. We discuss the principles of tertiary triage and methods for implementing such a system, emphasizing that these systems should serve only as a last resort. Even under triage, we must uphold our obligation to care for all patients as best possible under difficult circumstances.

  • Publication . Article . 2021
    Open Access
    Authors: 
    Kirsten M. Fiest; Karla D. Krewulak;
    Publisher: Elsevier BV