[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]
Crit Care Resusc. 2017 Sep;19(3):254-265.
A cross-sectional survey of Australian and New Zealand public opinion on methods totriage intensive care patients in an influenza pandemic.
Cheung W1, Myburgh J2, McGuinness S3, Chalmers D4, Parke R3, Blyth F5, Seppelt I6, Parr M7, Hooker C8, Blackwell N9, DeMonte S10, Gandhi K11, Kol M12, Kerridge I8, Nair P13, Saunders NM14, Saxena MK15, Thanakrishnan G12, Naganathan V5; Influenza Pandemic ICU Triage 3 study investigators; Australian and New Zealand Intensive Care Society Clinical Trials Group.
Author information: 1 Intensive Care Unit, Concord Repatriation General Hospital, Sydney, NSW, Australia. firstname.lastname@example.org. 2 Critical Care and Trauma Division, The George Institute for Global Health, Sydney, NSW, Australia. 3 Cardiothoracic and Vascular Intensive Care Unit, Auckland City Hospital, Auckland, New Zealand. 4 Intensive Care Unit, Hawke’s Bay Fallen Soldiers’ Memorial Hospital, Hastings, New Zealand. 5 Sydney Medical School, Concord, University of Sydney, Sydney, NSW, Australia. 6 Department of Intensive Care, Nepean Hospital, Sydney, NSW, Australia. 7 University of New South Wales, Sydney, NSW, Australia. 8 Centre for Values, Ethics and the Law in Medicine, University of Sydney, Sydney, NSW, Australia. 9 University of Queensland, Brisbane, QLD, Australia. 10 Prince Charles Hospital, Brisbane, QLD, Australia. 11 Department of Intensive Care, Blacktown Hospital, Sydney, NSW, Australia. 12 Intensive Care Unit, Concord Repatriation General Hospital, Sydney, NSW, Australia. 13 St. Vincent’s Hospital, Sydney, NSW, Australia. 14 Norfolk and Norwich University Hospital National Health Service Foundation Trust, Norfolk, United Kingdom. 15 Department of Intensive Care Medicine, St. George Hospital, Sydney, NSW, Australia.
BACKGROUND AND OBJECTIVE:
An influenza pandemic has the potential to overwhelm intensive care resources, but the views of the general public on how resources should be allocated in such a scenario were unknown. We aimed to determine Australian and New Zealand public opinion on how intensive care unit beds should be allocated during an influenza pandemic.
DESIGN, SETTING, AND PARTICIPANTS:
A postal questionnaire was sent to 4000 randomly selected registered voters; 2000 people each from the Australian Electoral Commission and New Zealand Electoral Commission rolls.
MAIN OUTCOME MEASURE:
The respondents’ preferred method to triage ICU patients in an influenza pandemic. Respondents chose from six methods: use a “first in, first served” approach; allow a senior doctor to decide; use pre-determined health department criteria; use random selection; use the patient’s ability to pay; use the importance of the patient to decide. Respondents also rated each of the triage methods for fairness.
Australian respondents preferred that patients be triaged to the ICU either by a senior doctor (43.2%) or by pre-determined health department criteria (38.7%). New Zealand respondents preferred that triage be performed by a senior doctor (45.9%). Respondents from both countries perceived triage by a senior doctor and by pre-determined health department criteria to be fair, and the other four methods of triage to be unfair.
In an influenza pandemic, when ICU resources would be overwhelmed, survey respondents preferred that ICU triage be performed by a senior doctor, but also perceived the use of pre-determined triage criteria to be fair.
Keywords: Pandemic Influenza; Pandemic Preparedness; Australia; New Zealand.