Articles: pandemics.
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Disaster Med Public Health Prep · Jun 2013
Information technology systems for critical care triage and medical response during an influenza pandemic: a review of current systems.
To assess local, state, federal, and global pandemic influenza preparedness by identifying pandemic plans at the local, state, federal, and global levels, and to identify any information technology (IT) systems in these plans to support critical care triage during an influenza pandemic in the Canadian province of Ontario. ⋯ Although several pandemic plans have been drafted, the majority are high-level general documents that do not describe IT systems. The plans that discuss IT systems focus strongly on surveillance, which fails to recognize the needs of a health care system responding to an influenza pandemic. The best examples of the types of IT systems to guide decision making during a pandemic were found in the Kansas and the Czech Republic pandemic plans, because these systems were designed to collect both patient and surveillance data. Although Ontario has yet to develop such an IT system, several IT systems are in place that could be leveraged to support critical care triage and medical response during an influenza pandemic.
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Here we report the case of a 9-year-old boy with acute respiratory distress syndrome (ARDS) caused by novel H1N1 swine-origin influenza virus A. A diagnosis of ARDS caused by a novel influenza A (H1N1) virus was made on the basis of chest X-ray and computed tomography together with low oxygenation index (OI) and the detection of novel influenza A (H1N1) virus from tracheal secretion samples. Oseltamivir phosphate and prone positioning were effective in the treatment of ARDS in this case. These findings suggest that anti-viral drugs and prone positioning can play an important role in the improvement of ARDS caused by novel H1N1 swine-origin influenza virus A.
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In a public health disaster, such as an influenza pandemic, the focus of medical care shifts from the needs of the individual to those of the community, so that the greatest good for the greatest number may be achieved. In a pandemic it will be necessary to maximize the benefit derived from all available local resources. Triage is the device employed to decide which patients will receive these limited medical resources. ⋯ Yet, based upon the severity of a pandemic it may be necessary and justifiable to include these criteria in making allocation decisions. The extent and manner of inclusion will directly correlate with pandemic severity. This paper considers existing protocols and proposes a manner for fully realizing the goals applicable in a public health crisis.