Listen folks. We have a shortage of ICU beds and ventilators, even if you work with the private sector. If & when serious cases surge, you will need to come up with criteria for resource-allocation/priority setting: who of the 4-5 or more clinically eligible, gets the ventilator?
So will you run a lottery, will you allow political pressures, will you choose age (young over old), will you use ability to pay, will you use healthy over those with co-morbidities?, etc?
Italy reportedly chose to preserve ventilators for those <60 and let older patients die!
Italy reportedly chose to preserve ventilators for those <60 and let older patients die!
These are not always clinical decisions, there is a lot of morality at play here. What frameworks do you use, how do you weigh your options? These decisions will take a toll on the involved teams. Its not easy to choose to let someone die for want of a machine.
Not to say it does not happen routinely-- it does because of our under-funded health system-- the deaths in ambulances while patients shuttled around hospitals searching for available ventilators, especially in public hospitals. or DAMA or LAMA to go die at home, not hospital
How many of our institutions have support mechanisms and ethical criteria/clinical ethics consult services to help make decisions about priority setting of limited resources objectively. Very few. And that is exactly the kind of support/framework you might need soon
#COVID19
#COVID19
Or this is what we might also have to do. I shudder at that thought. I seriously do.
