Research Group "Bioethics and Administration: Teaching and Health Care", Nursing School of University of São Paulo, São Paulo, SP, Brazil.
Departamento de Orientação Profissional, Escola de Enfermagem da Universidade de São Paulo, Rua Dr. Enéas de Carvalho Aguiar, 419, CEP - 05403-000 Cerqueira Cesar, São Paulo, SP, Brazil.
Crit Care. 2020 Sep 29;24(1):582. doi: 10.1186/s13054-020-03298-3.
After the World Health Organization declared COVID-19 to be a pandemic, the elaboration of comprehensive and preventive public policies became important in order to stop the spread of the disease. However, insufficient or ineffective measures may have placed health professionals and services in the position of having to allocate mechanical ventilators. This study aimed to identify instruments, analyze their structures, and present the main criteria used in the screening protocols, in order to help the development of guidelines and policies for the allocation of mechanical ventilators in the COVID-19 pandemic. The instruments have a low level of scientific evidence, and, in general, are structured by various clinical, non-clinical, and tiebreaker criteria that contain ethical aspects. Few instruments included public participation in their construction or validation. We believe that the elaboration of these guidelines cannot be restricted to specialists as this question involves ethical considerations which make the participation of the population necessary. Finally, we propose seventeen elements that can support the construction of screening protocols in the COVID-19 pandemic.
世界卫生组织宣布 COVID-19 大流行后，制定全面和预防为主的公共政策变得尤为重要，以阻止疾病的传播。然而，措施不足或无效可能使卫生专业人员和服务机构不得不分配机械呼吸机。本研究旨在确定相关工具，分析其结构，并介绍筛选方案中使用的主要标准，以帮助制定 COVID-19 大流行期间机械呼吸机分配的指南和政策。这些工具的科学证据水平较低，并且通常由各种临床、非临床和决胜标准构成，其中包含伦理方面的内容。很少有工具在构建或验证时纳入公众参与。我们认为，这些指南的制定不能仅限于专家，因为这个问题涉及到伦理考虑，需要民众的参与。最后，我们提出了十七个元素，可以支持 COVID-19 大流行期间筛选方案的构建。
