The New England Journal Of Medicine: The Toughest Triage — Allocating Ventilators in a Pandemic

The Toughest Triage — Allocating Ventilators in a Pandemic The Covid-19 pandemic has led to severe shortages of many essential goods and services, from hand sanitizers and N-95 masks to ICU beds and ventilators. Although rationing is not unprecedented, never before has the American public been faced with the prospect of having to ration medical goods and services on this scale. Of all the medical care that will have to be rationed, the most problematic will be mechanical ventilation. Several countries, but not the United States, have already experienced a shortage of ventilators. Although shortages of other goods and services may lead to deaths, in most cases it will be the combined effects of a variety of shortages that will result in worse outcomes. Mechanical ventilation is different. When patients’ breathing deteriorates to the point that they need a ventilator, there is typically only a limited window during which they can be saved. And when the machine is withdrawn from patients who are fully ventilator-dependent, they will usually die within minutes. Anticipating the need to allocate ventilators to the patients who are most likely to benefit, clinicians should proactively engage in discussions with patients and families regarding do-not-intubate orders for high-risk subgroups of patients before their health deteriorates. Once patients have already been placed on mechanical ventilation, decisions to withdraw it are especially fraught. In the weeks ahead, physicians in the United States may be asked to make decisions that they have never before had to face, and for which many of them will not be prepared. Though some people may denounce triage committees as “death panels,” in fact they would be just the opposite — their goal would be to save the most lives possible in a time of unprecedented crisis. To read more- Source-The New England Journal Of Medicine Authors- Robert D. Truog, M.D., Christine Mitchell, R.N., and George Q. Daley, M.D., Ph.D. Do Such situation may arise in India in the Near Future? Share your views Doctors.



Kindly follow the govt request for Lockdown... Its for all of us... Only we can control this outbreak with our joint effort.... Once this virus spreads to community, our country will perish....

Dear healers, 1. We cannot deny the fact we have limited equipments and along with the helplessness of daily workers. The efforts by the government are more or less not sufficient. Hopefully, these crises won't rise to the level of suffering as the other nations are facing. 2. According to our literature, fear of disease is more dangerous than the disease itself. By panicking we are getting susceptible to the disease. 3. The lockdown gave us the chance to relax and spend valuable time with our families. Being surrounded with the family always boost one's faith which ultimately lead to increase the immunity. 4. We always been a religious country who gave out best in the crisis. If I think scientifically too..then, navratri rituals in which camphor is used as one of its ingredients which has the properties of disinfectant. 5. This is a war which will be won by unity and its seen by the world in janta curfew on 22th March. Let's be together. 6. It's high time to raise our consciousness to the level of humanity. We are not only the population of 138 crores. Let's see them as 138 crore assets or human resources. So people, let your spirits vibrate high on the frequency where we visualise a healthy nation. Stay home. Stay united.

It mayiagree

Hello It will all depend upon how far the isolation is effective In india even 0.5 percent suffering at one point of time figure may 65 lacs cases which may be a most challenging & may be impossible So only effective to control strict home isolation for all May god bless the mother earth



@Dr. Dinesh Gupta @Partha Sarathi Sahana @Pushker Bhomia @Dr. Deepshikha Singh @Amitkumar Bose @Sandeep S

Is producing ventilators on a mass scale the only solution? If this pandemic goes in community transmission in india, no number of ventilators will be sufficient. No country can arrange this much of number. We have to prepare a better future strategy to deal such situations. There is a sure delay from China to report it. The international flights were banned at a very later stage WHO also declared it a pandemic ya a very latter stage Health sector has always been given less importance by very country compared to defence. Now the world needs to rethink on this issue . A tiny microscopic virus made the whole world helpless and still we human being thinks we are the most advanced developed creature in the evolution.

I agree with the fact.. and homoeopathy is the most evolved science and it can do miracles. I am not talking theoretically the results are speaking. I want everyone to see the interview of Rajiv Bajaj with Barkha Dutt. The efforts of Dr. Massimo mangilavori of Italy, Dr. Rajan Sankaran and Dr. P. vijayakar of mumbai in the crisis of corona virus are commendable. I am saying we have to work together for the benefit of the mankind along with the allopathic system of medicine.

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What are the main precautions sir

Why all the developed nations jointly start a new venture of producing ventillators on a mass scale

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