Introduction and executive summary: Care of the critically ill and injured during pandemics and disasters: CHEST consensus statement

Michael D. Christian, Asha V. Devereaux, Jeffrey R. Dichter, Lewis Rubinson, Niranjan Kissoon, Task Force for Mass Critical Care

Research output: Contribution to journalArticlepeer-review

67 Scopus citations


Natural disasters, industrial accidents, terrorism attacks, and pandemics all have the capacity to result in large numbers of critically ill or injured patients. This supplement provides suggestions for all of those involved in a disaster or pandemic with multiple critically ill patients, including front-line clinicians, hospital administrators, professional societies, and public health or government officials. The current Task Force included a total of 100 participants from nine countries, comprised of clinicians and experts from a wide variety of disciplines. Comprehensive literature searches were conducted to identify studies upon which evidence-based recommendations could be made. No studies of sufficient quality were identified. Therefore, the panel developed expert-opinion-based suggestions that are presented in this supplement using a modified Delphi process. The ultimate aim of the supplement is to expand the focus beyond the walls of ICUs to provide recommendations for the management of all critically ill or injured adults and children resulting from a pandemic or disaster wherever that care may be provided. Considerations for the management of critically ill patients include clinical priorities and logistics (supplies, evacuation, and triage) as well as the key enablers (systems planning, business continuity, legal framework, and ethical considerations) that facilitate the provision of this care. The supplement also aims to illustrate how the concepts of mass critical care are integrated across the spectrum of surge events from conventional through contingency to crisis standards of care.

Original languageEnglish (US)
Pages (from-to)8S-34S
StatePublished - Oct 1 2014

Bibliographical note

Funding Information:
Funding/Support: This publication was supported by the Cooperative Agreement Number 1U90TP00591-01 from the Centers of Disease Control and Prevention, and through a research sub award agreement through the Department of Health and Human Services grant Number 1 - HFPEP070013-01-00 from the Office of Preparedness of Emergency Operations. In addition, this publication was supported by a grant from the University of California–Davis.

Funding Information:
1a. We suggest political leadership at national levels should support health-care preparedness through financial assistance, support of market driven incentives, and preparedness requirements to health-care coalitions/regional health authorities (HC/RHAs).

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