Influenza Plans...

Don Rearic

Don Rearic

Joined
Oct 8, 1998
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I had to trim this severely due to the law on posting news articles, this should be OK. It's educational, after all.

Who Should Not Be Saved in a Pandemic?
By LINDSEY TANNER,AP
Posted: 2008-05-05 13:28:17
Filed Under: Health News

CHICAGO (May 5) - Doctors know some patients needing lifesaving care won't get it in a flu pandemic or other disaster. The gut-wrenching dilemma will be deciding who to let die.

Now, an influential group of physicians has drafted a grimly specific list of recommendations for which patients wouldn't be treated. They include the very elderly, seriously hurt trauma victims, severely burned patients and those with severe dementia.

The suggested list was compiled by a task force whose members come from prestigious universities, medical groups, the military and government agencies. They include the Department of Homeland Security, the Centers for Disease Control and Prevention and the Department of Health and Human Services.

The proposed guidelines are designed to be a blueprint for hospitals "so that everybody will be thinking in the same way" when pandemic flu or another widespread health care disaster hits, said Dr. Asha Devereaux. She is a critical care specialist in San Diego and lead writer of the task force report.

The idea is to try to make sure that scarce resources - including ventilators, medicine and doctors and nurses - are used in a uniform, objective way, task force members said.

Their recommendations appear in a report appearing Monday in the May edition of Chest, the medical journal of the American College of Chest Physicians.

"If a mass casualty critical care event were to occur tomorrow, many people with clinical conditions that are survivable under usual health care system conditions may have to forgo life-sustaining interventions owing to deficiencies in supply or staffing," the report states.

To prepare, hospitals should designate a triage team with the Godlike task of deciding who will and who won't get lifesaving care, the task force wrote. Those out of luck are the people at high risk of death and a slim chance of long-term survival. But the recommendations get much more specific, and include:

-- People older than 85.

-- Those with severe trauma, which could include critical injuries from car crashes and shootings.

-- Severely burned patients older than 60.

-- Those with severe mental impairment, which could include advanced Alzheimer's disease.

-- Those with a severe chronic disease, such as advanced heart failure, lung disease or poorly controlled diabetes.

Copyright 2008 The Associated Press. The information contained in the AP news report may not be published, broadcast, rewritten or otherwise distributed without the prior written authority of The Associated Press. All active hyperlinks have been inserted by AOL.
2008-05-05 09:25:41
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All I have to say is...damn. What's next? Some wizard standing there asking questions like, "Wie sind Sie Mutter? Haben Sie kurzatmigkeit?"
 
It's an ugly situation but the logic speaks for itself. If resources are limited, not everyone can be treated.

It sucks, but it's just the reality.

This effects me quite a bit because I have a daughter with Down syndrome and a grandmother living with me with severe dementia.

If someone were to tell me they couldn't treat my Grandmother, I would be upset but deep down I would understand.

If someone were to tell me they couldn't treat my little girl because of her disability, there would be blood.
 
shotgunner11 said:
It's an ugly situation but the logic speaks for itself. If resources are limited, not everyone can be treated.

It sucks, but it's just the reality.

This effects me quite a bit because I have a daughter with Down syndrome and a grandmother living with me with severe dementia.

If someone were to tell me they couldn't treat my Grandmother, I would be upset but deep down I would understand.

If someone were to tell me they couldn't treat my little girl because of her disability, there would be blood.
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Agreed. It will come down to save those that can be saved. People with severe medical problems, as well as many others will not be considered "viable" candidates (to put it as P.C. as possible) for treatment.

May smack of wrong, but the reality of a very bad situation alway does.
 
shotgunner11 said:
This effects me quite a bit because I have a daughter with Down syndrome and a grandmother living with me with severe dementia.

If someone were to tell me they couldn't treat my Grandmother, I would be upset but deep down I would understand.

If someone were to tell me they couldn't treat my little girl because of her disability
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It sounds like the goal is to use resources as efficiently as possible rather than to implement some sort of darwinian plan or eugenics program. I don't know much about Down syndrome, but unless it would reduce the effectiveness of the influenza treatment, I don't see the report as arguing that those affected shouldn't be treated.

there would be blood.
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In a SHTF situation of this sort, there will be a lot of violence in that nature. I can see National Guardsmen being stationed in hospitals to keep order and protect medical professionals.
 
Triage is a fact of life, but posting blatant standards is a bad idea. It puts certian people into the "expendable" category before treatment has even begun.
 
STAGE 2 said:
Triage is a fact of life, but posting blatant standards is a bad idea. It puts certian people into the "expendable" category before treatment has even begun.
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I'm not sure about that - think of the mayhem that would ensue without guidelines. Also, without something concrete, a lot of doctors might develop some serious psychological issues and not be able to work at peak capacity or even at all.
 
It has been since the eighties since I was in the military but they have been using similar triage since at least then. Basically the most likely to survive were given the first priority and the least likely were made comfortable and left to die.Sucks, but true.
 
angle iron said:
It has been since the eighties since I was in the military but they have been using similar triage since at least then. Basically the most likely to survive were given the first priority and the least likely were made comfortable and left to die.Sucks, but true.
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A bit unrelated, but I just read a great article in Discover magazine about U.S. military medicine. Apparently the primary care system set up in Iraq and Afghanistan is one of the best medical systems ever devised - the long road after that certainly has many problems, but it is great to hear about the things that military hospitals are now able to do. Hopefully, soldiers on the ground will soon be an antiquated concept.
 
Nothing wrong with a darwinian plan though....LOL...seriously though deperate times call for desperate measures... this country invests alot of money and manpower into.....actually I'll stop don't want to get my dander up....contemplating things like this sucks...I'd carry some purel wash you hands alot by some HEPA masks and latex gloves for when things get real, if they do. A flu pandemic can potentially be a terrible thing, but theres not much anyhone can do except try to be prepared.
 
If such a pandemic hits what's the best survival plan?

How long would such a pandemic last and how long would the world remain infected after it's settled down?

If its short enough, you could just hunker down with plenty of food and water if you live in the open suburbs or country. If you're stuck in an apartment complex or other building with central air, I guess the only sure thing to do is bug out.


RescueRiley said:
Nothing wrong with a darwinian plan though
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I don't want to start any fights, but it's worth noting that 34 U.S. states had active eugenics programs before Hitler came along with his final solution.
 
If you haven't had the pleasure of bing in the emergency room in say the last five years you should stop by and take a look. The normal day to day accidents and illnesses have completely overwhelmed even the best prepared hospitals in the country. It is not unheard of where I live to wait in the emrgency room for more than six hours. Even if your injury or illness is severe. Stop by on a Friday or Saturday night with the shootings, drunk drivers, and bar fights and see the chaos.
Don't imagine for a moment that if you land in the hospital during a particularly nasty flu that affects the respiratory system that they will have a ventilator for you. Even the biggest hospital in the country won't have more than 100 ventilators. If an epidemic caused more than 100 people to fall ill and all needed a ventilator then the next patient will be sorely lacking medical equipment to help them.
 
Well said slippse2.

I'm going to try to learn some more about the flu. Critical information being: Details of its methods of spreading, how fast geographically it spreads, how long of an incubation period, how long of a sick period, and how long the entire epidemic lasts.
 
Its not an easy task to triage. Ive done it many times with bad mass casulty car crashes. IT HAS TO BE DONE THOUGH. It is an unfortunate part of the job, but without proticals put into place a mci can quickly turn into a clusterf*@$. I need guidelines to follow to help better insure survival of viable pts. It is just a glimpse into the planning stages of a pandemic. I think the guidelines outlined in that article are very realistic, and not outrageous at all....
 
I hate to be "that crazy conspiracy guy", but I wonder if the U.S. gov't would implement any sort of quarantines, detention centers, or forced evacuations.
 
i understand the frustration and anger about the system of triage, but if you had to make the decision about who to give very scarce resources to and who not to how would you do it? in the time of mass csualty or pandemic there simply wont be enough medical resources to handle all the oif the patients, so if it makes you angry then tell me a better way. since it is not possible to design a mass casualty system that will handle all the needs of all the patients that will present to the emergency system the patients that are the most survivable will get care first. the patients that are the least survivable will get care last. that is the logic of triage, so that you can salvage the most with the resources that you have. would you sacrifice a 20 year old otherwise healthy individual to save an 80 year old with terminal cancer, no that is not rational, the bigger problem exists as to how will the healthcare system function with the loss of so many workers from the pandemic?

alex
 
The difference between triage and eugenics is immense. A government program to pick which people or groups to put out of the way is inhumane. A medical program to treat the most likely individuals to survive first is a logical necessity. The prospect of running out of resources and people to help everyone in case of a widespread disaster is best approached by planning, of which triage is a part.

Increasing resources to match likely threats is another part. People getting vaccinated for flu cuts back on potential victims, releasing scarce resources for others. Stockpiling food in case of civil breakdown helps also.

Complaining that the government isn't doing enough for all of us is lame. Let's raise taxes and increase Homeland Security's authority, then we'll all be all right, huh?
 
Two things I think aren't at all too remote to consider right now:

(1) For those whose jobs might work this way, consider how you might be able to telecommute; even if your workplace won't allow it now, you might plant the seeds of the idea in the mind of whoever sets those policies at your workplace.

(2) Get enough of an idea about how to homeschool your kids (if you have them), now, so that you could pull them out of school and get homeschooling (like, have curriculum picked out, and know the local legalities) with about one or two days' notice. If there is a serious epidemic, a lot of kids (and families with kids) are going to be dead unless someone sees it coming a long way off and takes appropriate preventive action. Kids have ZERO sense about infection control; you can't get them to keep their hands out of their mouths for 20 minutes; so the key is going to have to be figuring out the practicalities of isolating them from the rest of the infected population until it all blows over.
 
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