LAUSR

Triage Team Guidelines. 5. Discuss lessons learned and future considerations regarding scarce resource allocation. Background: In a disaster situation when resources are scarce, it’s agreed that health care providers have a duty to care, but also a duty to steward resources within an ethical framework. Operationalizing these ideals is challenging, especially when pediatric critical care itself is limited and specialized. The population of Washington state is 7.1 million, with 22.5% <18 years. There are only 119 PICU beds in the state, and only 30% are open at any time. During an overwhelming disaster, the number of critically injured and ill children may exceed resources available in spite of conservation and surge strategies. The NWHRN established the DCAC in 2012 to bring regional clinical leaders together to discuss scarce resource allocation. Methods: Using a modeling tool developed by the US CDC, we estimated the potential pediatric critical care needs during a pandemic. We then gathered data regarding regional pediatric critical care resources, reviewed current literature, discussed conservation and surge strategies, and developed the Pediatric Critical Care Algorithm, Worksheet, and Triage Team Guidelines. Results: The King/Pierce County Pediatric Critical Care Triage Algorithm and accompanying Worksheet are to be used with the Triage Team Guidelines. These documents are part of a regional Concept of Operations for Scarce Resource Management Plan. Conclusion: This presentation outlines our process and provides our regional recommendations for pediatric critical care triage, as well as lessons learned and future recommendations. IOM reports Crisis Standards of Care 2009. Kissoon N. Deliberations and recommendations of the Pediatric Emergency Mass Critical Care Task Force: Executive summary. Pediatr Crit Care Med. 2011;12:S103-108. USA Census. gov est 2015.