Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Crit Care Med. 2011 Nov;39(11):2534-9. doi: 10.1097/CCM.0b013e3182326440.
In recent years, healthcare disaster planning has grown from its early place as an occasional consideration within the manuals of emergency medical services and emergency department managers to a rapidly growing field, which considers continuity of function, surge capability, and process changes across the spectrum of healthcare delivery. A detailed examination of critical care disaster planning was undertaken in 2007 by the Task Force for Mass Critical Care of the American College of Chest Physicians Critical Care Collaborative Initiative. We summarize the Task Force recommendations and available updated information to answer a fundamental question for critical care disaster planners: What is a prepared intensive care unit and how do I ensure my unit's readiness?
Database searches and review of relevant published literature.
Preparedness is essential for successful response, but because intensive care units face many competing priorities, without defining "preparedness for what," the task can seem overwhelming. Intensive care unit disaster planners should, therefore, along with the entire hospital, participate in a hospital or regionwide planning process to 1) identify critical care response vulnerabilities; and 2) clarify the hazards for which their community is most at risk. The process should inform a comprehensive written preparedness plan targeting the most worrisome scenarios and including specific guidance on 1) optimal use of space, equipment, and staffing for delivery of critical care to significantly increased patient volumes; 2) allocation of resources for provision of essential critical care services under conditions of absolute scarcity; 3) intensive care unit evacuation; and 4) redundant internal communication systems and means for timely data collection.
Critical care disaster planners have a complex, challenging task. Experienced planners will agree that no disaster response is perfect, but careful planning will enable the prepared intensive care unit to respond effectively in times of crisis.
近年来，医疗保健灾难规划已从早期偶尔在急诊医疗服务和急诊部门管理人员的手册中考虑，发展成为一个快速发展的领域，该领域考虑了功能连续性、浪涌能力以及整个医疗保健提供范围内的流程变化。美国胸科医师学会重症监护协作倡议的大规模重症监护任务组于 2007 年对重症监护灾难规划进行了详细检查。我们总结了任务组的建议和可用的最新信息，以回答重症监护灾难规划者的一个基本问题：什么是准备好的重症监护病房，我如何确保我的单位的准备就绪？
数据库搜索和相关已发表文献的审查。
准备工作对于成功应对至关重要，但由于重症监护病房面临许多相互竞争的优先事项，如果不定义“为应对什么做好准备”，则任务似乎令人望而却步。因此，重症监护病房灾难规划者应与整个医院一起参与医院或区域规划过程，以 1）确定重症监护反应的脆弱性；2）明确其社区面临最大风险的危害。该过程应告知针对最令人担忧的情况制定全面的书面准备计划，并包括以下具体指导：1）为显著增加患者数量提供重症监护时，最佳利用空间、设备和人员配置；2）在资源绝对稀缺的情况下，为提供基本重症监护服务分配资源；3）重症监护病房疏散；4）内部冗余通信系统和及时数据收集手段。
重症监护灾难规划者面临着复杂而具有挑战性的任务。有经验的规划者将同意，没有完美的灾难应对，但精心规划将使准备好的重症监护病房能够在危机时刻有效应对。
