• Janice L Zimmerman, Charles L Sprung, and European Society of Intensive Care Medicine's Task Force for intensive care unit triage during an influenza epidemic or mass disaster.
• Critical Care Division, Department of Medicine, The Methodist Hospital, Houston, TX, USA.
• Intensive Care Med. 2010 Apr 1; 36 Suppl 1: S65-9.

PurposeTo provide recommendations and standard operating procedures for intensive care unit and hospital preparations for an influenza pandemic or mass disaster with a specific focus on ensuring that adequate resources are available and appropriate protocols are developed to safely perform procedures in patients with and without influenza illness.MethodsBased on a literature review and expert opinion, a Delphi process was used to define the essential topics including performing medical procedures.ResultsKey recommendations include: (1) specify high-risk procedures (aerosol generating-procedures); (2) determine if certain procedures will not be performed during a pandemic; (3) develop protocols for safe performance of high-risk procedures that include appropriateness, qualifications of personnel, site, personal protection equipment, safe technique and equipment needs; (4) ensure adequate training of personnel in high-risk procedures; (5) procedures should be performed at the bedside whenever possible; (6) ensure safe respiratory therapy practices to avoid aerosols; (7) provide safe respiratory equipment; and (8) determine criteria for cancelling and/or altering elective procedures.ConclusionsJudicious planning and adoption of protocols for safe performance of medical procedures are necessary to optimize outcomes during a pandemic.

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