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Care of the Critically Ill and Injured During Pandemics and DisastersGroundbreaking Results on Mass Critical Care: Groundbreaking Results from the Task Force on Mass Critical Care

Christian E. Sandrock, MD, MPH, FCCP
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From the Intensive Care Unit, Division of Pulmonary and Critical Care, Division of Infectious Diseases, University of California, Davis School of Medicine.

CORRESPONDENCE TO: Christian E. Sandrock, MD, MPH, FCCP, Intensive Care Unit, Division of Pulmonary and Critical Care, Division of Infectious Diseases, University of California, Davis School of Medicine, 4150 V St #3400, Sacramento, CA 95817; e-mail: cesandrock@ucdavis.edu


FINANCIAL/NONFINANCIAL DISCLOSURES: The authors have reported to CHEST that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2014;146(4):881-883. doi:10.1378/chest.14-1900
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The critically ill are a unique group of patients in a disaster response setting because they require resource-intensive care, advanced and costly therapies, and specialized settings and providers to deliver this care.1,2 They can present as a sudden surge of patients over a short period of time, pushing the limits of the health-care facility, or they can present over a sustained period of time, such as was the case of the 2009 influenza A(H1N1) pandemic, straining the larger regional health system. In many disasters, such as the London bombings, the critically ill can present as both an immediate surge and as a sustained intensive response, thus presenting varying response needs throughout the disaster.2,3 This variability with the most critically ill creates uncertainty in health-care response because local, regional, and national health-care systems may have resource limitations, a paucity of medical expertise, and structural compromise of health-care clinics and hospitals at any given moment. The current Ebola outbreak in West Africa best highlights the difficulties surrounding critically ill patients in a very resource-limited environment. However, regardless of the type of disaster and the extent of the critically ill, planning for this uncertainty in mass critical care is paramount to ensuring good patient outcomes.3-5

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