Operationalization of critical care triage during a pandemic surge using protocolized communication and integrated supportive care View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2020-08-06

AUTHORS

Devanand Anantham, Crystal Chai-Lim, Jamie Xuelian Zhou, Ghee Chee Phua

ABSTRACT

Triage becomes necessary when demand for intensive care unit (ICU) resources exceeds supply. Without triage, there is a risk that patients will be admitted to the ICU in the sequence that they present, disadvantaging those who either present later or have poorer access to healthcare. Moreover, if the patients with the best prognosis are not allocated life support, there is the possibility that overall mortality will increase. Before formulating criteria, principles such as maximizing lives saved and fairness ought to have been agreed upon to guide decision-making. The triage process is subdivided into three parts, i.e., having explicit inclusion/exclusion criteria for ICU admission, prioritization of patients for allocation to available beds, and periodic reassessment of all patients already admitted to the ICU. Multi-dimensional criteria offer more holistic prognostication than only using age cutoffs. Appointed triage officers should also be enabled to make data-driven decisions. However, the process does not merely end with an allocation decision being made. Any decision has to be sensitively and transparently communicated to the patient and family. With infection control measures, there are challenges in managing communication and the psychosocial distress of dying alone. Therefore, explicit video call protocols and social services expertise will be necessary to mitigate these challenges. Besides symptom management and psychosocial management, supportive care teams play an integral role in coordination of complex cases. This scoping review found support for the three-pronged, triage-communication-supportive care approach to facilitate the smooth operationalization of the triage process in a pandemic. More... »

PAGES

59

Identifiers

URI

http://scigraph.springernature.com/pub.10.1186/s40560-020-00475-y

DOI

http://dx.doi.org/10.1186/s40560-020-00475-y

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1129897077

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/32834898


Indexing Status Check whether this publication has been indexed by Scopus and Web Of Science using the SN Indexing Status Tool
Incoming Citations Browse incoming citations for this publication using opencitations.net

JSON-LD is the canonical representation for SciGraph data.

TIP: You can open this SciGraph record using an external JSON-LD service: JSON-LD Playground Google SDTT

[
  {
    "@context": "https://springernature.github.io/scigraph/jsonld/sgcontext.json", 
    "about": [
      {
        "id": "http://purl.org/au-research/vocabulary/anzsrc-for/2008/11", 
        "inDefinedTermSet": "http://purl.org/au-research/vocabulary/anzsrc-for/2008/", 
        "name": "Medical and Health Sciences", 
        "type": "DefinedTerm"
      }, 
      {
        "id": "http://purl.org/au-research/vocabulary/anzsrc-for/2008/1117", 
        "inDefinedTermSet": "http://purl.org/au-research/vocabulary/anzsrc-for/2008/", 
        "name": "Public Health and Health Services", 
        "type": "DefinedTerm"
      }
    ], 
    "author": [
      {
        "affiliation": {
          "alternateName": "Department of Respiratory and Critical Care Medicine, Singapore General Hospital, Academia Building Level 3, 20 College Road, S169856, Singapore, Singapore", 
          "id": "http://www.grid.ac/institutes/grid.163555.1", 
          "name": [
            "Duke-NUS Medical School, Singapore, Singapore", 
            "Department of Respiratory and Critical Care Medicine, Singapore General Hospital, Academia Building Level 3, 20 College Road, S169856, Singapore, Singapore"
          ], 
          "type": "Organization"
        }, 
        "familyName": "Anantham", 
        "givenName": "Devanand", 
        "id": "sg:person.0752666000.97", 
        "sameAs": [
          "https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.0752666000.97"
        ], 
        "type": "Person"
      }, 
      {
        "affiliation": {
          "alternateName": "Medical Social Services Department, Singapore General Hospital, Singapore, Singapore", 
          "id": "http://www.grid.ac/institutes/grid.163555.1", 
          "name": [
            "Duke-NUS Medical School, Singapore, Singapore", 
            "Medical Social Services Department, Singapore General Hospital, Singapore, Singapore"
          ], 
          "type": "Organization"
        }, 
        "familyName": "Chai-Lim", 
        "givenName": "Crystal", 
        "id": "sg:person.015447712161.26", 
        "sameAs": [
          "https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.015447712161.26"
        ], 
        "type": "Person"
      }, 
      {
        "affiliation": {
          "alternateName": "Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore", 
          "id": "http://www.grid.ac/institutes/grid.410724.4", 
          "name": [
            "Duke-NUS Medical School, Singapore, Singapore", 
            "Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore"
          ], 
          "type": "Organization"
        }, 
        "familyName": "Zhou", 
        "givenName": "Jamie Xuelian", 
        "id": "sg:person.013251005701.24", 
        "sameAs": [
          "https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.013251005701.24"
        ], 
        "type": "Person"
      }, 
      {
        "affiliation": {
          "alternateName": "Department of Respiratory and Critical Care Medicine, Singapore General Hospital, Academia Building Level 3, 20 College Road, S169856, Singapore, Singapore", 
          "id": "http://www.grid.ac/institutes/grid.163555.1", 
          "name": [
            "Duke-NUS Medical School, Singapore, Singapore", 
            "Department of Respiratory and Critical Care Medicine, Singapore General Hospital, Academia Building Level 3, 20 College Road, S169856, Singapore, Singapore"
          ], 
          "type": "Organization"
        }, 
        "familyName": "Phua", 
        "givenName": "Ghee Chee", 
        "id": "sg:person.0704526420.08", 
        "sameAs": [
          "https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.0704526420.08"
        ], 
        "type": "Person"
      }
    ], 
    "citation": [
      {
        "id": "sg:pub.10.1186/s13613-017-0293-2", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1086099795", 
          "https://doi.org/10.1186/s13613-017-0293-2"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "sg:pub.10.1186/cc12736", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1044011276", 
          "https://doi.org/10.1186/cc12736"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "sg:pub.10.1007/s00134-017-4891-0", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1091344285", 
          "https://doi.org/10.1007/s00134-017-4891-0"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "sg:pub.10.1186/s41018-018-0033-8", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1103462304", 
          "https://doi.org/10.1186/s41018-018-0033-8"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "sg:pub.10.1007/s00134-015-4098-1", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1018177387", 
          "https://doi.org/10.1007/s00134-015-4098-1"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "sg:pub.10.1017/cem.2020.358", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1126059139", 
          "https://doi.org/10.1017/cem.2020.358"
        ], 
        "type": "CreativeWork"
      }
    ], 
    "datePublished": "2020-08-06", 
    "datePublishedReg": "2020-08-06", 
    "description": "Triage becomes necessary when demand for intensive care unit (ICU) resources exceeds supply. Without triage, there is a risk that patients will be admitted to the ICU in the sequence that they present, disadvantaging those who either present later or have poorer access to healthcare. Moreover, if the patients with the best prognosis are not allocated life support, there is the possibility that overall mortality will increase. Before formulating criteria, principles such as maximizing lives saved and fairness ought to have been agreed upon to guide decision-making. The triage process is subdivided into three parts, i.e., having explicit inclusion/exclusion criteria for ICU admission, prioritization of patients for allocation to available beds, and periodic reassessment of all patients already admitted to the ICU. Multi-dimensional criteria offer more holistic prognostication than only using age cutoffs. Appointed triage officers should also be enabled to make data-driven decisions. However, the process does not merely end with an allocation decision being made. Any decision has to be sensitively and transparently communicated to the patient and family. With infection control measures, there are challenges in managing communication and the psychosocial distress of dying alone. Therefore, explicit video call protocols and social services expertise will be necessary to mitigate these challenges. Besides symptom management and psychosocial management, supportive care teams play an integral role in coordination of complex cases. This scoping review found support for the three-pronged, triage-communication-supportive care approach to facilitate the smooth operationalization of the triage process in a pandemic.", 
    "genre": "article", 
    "id": "sg:pub.10.1186/s40560-020-00475-y", 
    "isAccessibleForFree": true, 
    "isPartOf": [
      {
        "id": "sg:journal.1049769", 
        "issn": [
          "2052-0492"
        ], 
        "name": "Journal of Intensive Care", 
        "publisher": "Springer Nature", 
        "type": "Periodical"
      }, 
      {
        "issueNumber": "1", 
        "type": "PublicationIssue"
      }, 
      {
        "type": "PublicationVolume", 
        "volumeNumber": "8"
      }
    ], 
    "keywords": [
      "intensive care unit resources", 
      "explicit inclusion/exclusion criteria", 
      "critical care triage", 
      "supportive care team", 
      "supportive care approaches", 
      "infection control measures", 
      "inclusion/exclusion criteria", 
      "triage process", 
      "prioritization of patients", 
      "ICU admission", 
      "supportive care", 
      "better prognosis", 
      "overall mortality", 
      "symptom management", 
      "care team", 
      "psychosocial distress", 
      "care triage", 
      "exclusion criteria", 
      "age cutoff", 
      "psychosocial management", 
      "care approach", 
      "pandemic surge", 
      "patients", 
      "life support", 
      "available beds", 
      "poor access", 
      "triage", 
      "periodic reassessment", 
      "ICU", 
      "triage officer", 
      "unit resources", 
      "integral role", 
      "control measures", 
      "complex cases", 
      "prognosis", 
      "admission", 
      "mortality", 
      "prognostication", 
      "criteria", 
      "care", 
      "management", 
      "risk", 
      "distress", 
      "pandemic", 
      "review", 
      "healthcare", 
      "cutoff", 
      "support", 
      "cases", 
      "life", 
      "team", 
      "protocol", 
      "role", 
      "measures", 
      "reassessment", 
      "challenges", 
      "decisions", 
      "family", 
      "surge", 
      "access", 
      "expertise", 
      "bed", 
      "multi-dimensional criteria", 
      "possibility", 
      "part", 
      "communication", 
      "prioritization", 
      "coordination", 
      "process", 
      "officers", 
      "operationalization", 
      "supply", 
      "approach", 
      "sequence", 
      "allocation decisions", 
      "service expertise", 
      "data-driven decision", 
      "resources", 
      "principles", 
      "allocation", 
      "demand", 
      "fairness"
    ], 
    "name": "Operationalization of critical care triage during a pandemic surge using protocolized communication and integrated supportive care", 
    "pagination": "59", 
    "productId": [
      {
        "name": "dimensions_id", 
        "type": "PropertyValue", 
        "value": [
          "pub.1129897077"
        ]
      }, 
      {
        "name": "doi", 
        "type": "PropertyValue", 
        "value": [
          "10.1186/s40560-020-00475-y"
        ]
      }, 
      {
        "name": "pubmed_id", 
        "type": "PropertyValue", 
        "value": [
          "32834898"
        ]
      }
    ], 
    "sameAs": [
      "https://doi.org/10.1186/s40560-020-00475-y", 
      "https://app.dimensions.ai/details/publication/pub.1129897077"
    ], 
    "sdDataset": "articles", 
    "sdDatePublished": "2022-08-04T17:08", 
    "sdLicense": "https://scigraph.springernature.com/explorer/license/", 
    "sdPublisher": {
      "name": "Springer Nature - SN SciGraph project", 
      "type": "Organization"
    }, 
    "sdSource": "s3://com-springernature-scigraph/baseset/20220804/entities/gbq_results/article/article_840.jsonl", 
    "type": "ScholarlyArticle", 
    "url": "https://doi.org/10.1186/s40560-020-00475-y"
  }
]
 

Download the RDF metadata as:  json-ld nt turtle xml License info

HOW TO GET THIS DATA PROGRAMMATICALLY:

JSON-LD is a popular format for linked data which is fully compatible with JSON.

curl -H 'Accept: application/ld+json' 'https://scigraph.springernature.com/pub.10.1186/s40560-020-00475-y'

N-Triples is a line-based linked data format ideal for batch operations.

curl -H 'Accept: application/n-triples' 'https://scigraph.springernature.com/pub.10.1186/s40560-020-00475-y'

Turtle is a human-readable linked data format.

curl -H 'Accept: text/turtle' 'https://scigraph.springernature.com/pub.10.1186/s40560-020-00475-y'

RDF/XML is a standard XML format for linked data.

curl -H 'Accept: application/rdf+xml' 'https://scigraph.springernature.com/pub.10.1186/s40560-020-00475-y'


 

This table displays all metadata directly associated to this object as RDF triples.

194 TRIPLES      21 PREDICATES      113 URIs      99 LITERALS      7 BLANK NODES

Subject Predicate Object
1 sg:pub.10.1186/s40560-020-00475-y schema:about anzsrc-for:11
2 anzsrc-for:1117
3 schema:author Nc729a1ed616448af8bf93e0c224d924d
4 schema:citation sg:pub.10.1007/s00134-015-4098-1
5 sg:pub.10.1007/s00134-017-4891-0
6 sg:pub.10.1017/cem.2020.358
7 sg:pub.10.1186/cc12736
8 sg:pub.10.1186/s13613-017-0293-2
9 sg:pub.10.1186/s41018-018-0033-8
10 schema:datePublished 2020-08-06
11 schema:datePublishedReg 2020-08-06
12 schema:description Triage becomes necessary when demand for intensive care unit (ICU) resources exceeds supply. Without triage, there is a risk that patients will be admitted to the ICU in the sequence that they present, disadvantaging those who either present later or have poorer access to healthcare. Moreover, if the patients with the best prognosis are not allocated life support, there is the possibility that overall mortality will increase. Before formulating criteria, principles such as maximizing lives saved and fairness ought to have been agreed upon to guide decision-making. The triage process is subdivided into three parts, i.e., having explicit inclusion/exclusion criteria for ICU admission, prioritization of patients for allocation to available beds, and periodic reassessment of all patients already admitted to the ICU. Multi-dimensional criteria offer more holistic prognostication than only using age cutoffs. Appointed triage officers should also be enabled to make data-driven decisions. However, the process does not merely end with an allocation decision being made. Any decision has to be sensitively and transparently communicated to the patient and family. With infection control measures, there are challenges in managing communication and the psychosocial distress of dying alone. Therefore, explicit video call protocols and social services expertise will be necessary to mitigate these challenges. Besides symptom management and psychosocial management, supportive care teams play an integral role in coordination of complex cases. This scoping review found support for the three-pronged, triage-communication-supportive care approach to facilitate the smooth operationalization of the triage process in a pandemic.
13 schema:genre article
14 schema:isAccessibleForFree true
15 schema:isPartOf N0624098d20664a2abb548f9cf36a7086
16 N33f1865065444ff7856e610b5cae2f4e
17 sg:journal.1049769
18 schema:keywords ICU
19 ICU admission
20 access
21 admission
22 age cutoff
23 allocation
24 allocation decisions
25 approach
26 available beds
27 bed
28 better prognosis
29 care
30 care approach
31 care team
32 care triage
33 cases
34 challenges
35 communication
36 complex cases
37 control measures
38 coordination
39 criteria
40 critical care triage
41 cutoff
42 data-driven decision
43 decisions
44 demand
45 distress
46 exclusion criteria
47 expertise
48 explicit inclusion/exclusion criteria
49 fairness
50 family
51 healthcare
52 inclusion/exclusion criteria
53 infection control measures
54 integral role
55 intensive care unit resources
56 life
57 life support
58 management
59 measures
60 mortality
61 multi-dimensional criteria
62 officers
63 operationalization
64 overall mortality
65 pandemic
66 pandemic surge
67 part
68 patients
69 periodic reassessment
70 poor access
71 possibility
72 principles
73 prioritization
74 prioritization of patients
75 process
76 prognosis
77 prognostication
78 protocol
79 psychosocial distress
80 psychosocial management
81 reassessment
82 resources
83 review
84 risk
85 role
86 sequence
87 service expertise
88 supply
89 support
90 supportive care
91 supportive care approaches
92 supportive care team
93 surge
94 symptom management
95 team
96 triage
97 triage officer
98 triage process
99 unit resources
100 schema:name Operationalization of critical care triage during a pandemic surge using protocolized communication and integrated supportive care
101 schema:pagination 59
102 schema:productId N1e8018c9469e4d34945abac95d5a11fe
103 Nbbe7cbc1b3f74bb7b7559b12ddff88f6
104 Nc09e37030656407fbc621a6610f7795b
105 schema:sameAs https://app.dimensions.ai/details/publication/pub.1129897077
106 https://doi.org/10.1186/s40560-020-00475-y
107 schema:sdDatePublished 2022-08-04T17:08
108 schema:sdLicense https://scigraph.springernature.com/explorer/license/
109 schema:sdPublisher N6e32e23442e242559b97311bcac0d973
110 schema:url https://doi.org/10.1186/s40560-020-00475-y
111 sgo:license sg:explorer/license/
112 sgo:sdDataset articles
113 rdf:type schema:ScholarlyArticle
114 N0624098d20664a2abb548f9cf36a7086 schema:issueNumber 1
115 rdf:type schema:PublicationIssue
116 N1e8018c9469e4d34945abac95d5a11fe schema:name dimensions_id
117 schema:value pub.1129897077
118 rdf:type schema:PropertyValue
119 N33f1865065444ff7856e610b5cae2f4e schema:volumeNumber 8
120 rdf:type schema:PublicationVolume
121 N58a2b90f0b4f4acdaba77118bdfaecbd rdf:first sg:person.0704526420.08
122 rdf:rest rdf:nil
123 N6e32e23442e242559b97311bcac0d973 schema:name Springer Nature - SN SciGraph project
124 rdf:type schema:Organization
125 Nb39c48bb40cc4845b3424a68bfcab8cb rdf:first sg:person.015447712161.26
126 rdf:rest Nba84c299fb0c499f9b407f9a6ee7a204
127 Nba84c299fb0c499f9b407f9a6ee7a204 rdf:first sg:person.013251005701.24
128 rdf:rest N58a2b90f0b4f4acdaba77118bdfaecbd
129 Nbbe7cbc1b3f74bb7b7559b12ddff88f6 schema:name doi
130 schema:value 10.1186/s40560-020-00475-y
131 rdf:type schema:PropertyValue
132 Nc09e37030656407fbc621a6610f7795b schema:name pubmed_id
133 schema:value 32834898
134 rdf:type schema:PropertyValue
135 Nc729a1ed616448af8bf93e0c224d924d rdf:first sg:person.0752666000.97
136 rdf:rest Nb39c48bb40cc4845b3424a68bfcab8cb
137 anzsrc-for:11 schema:inDefinedTermSet anzsrc-for:
138 schema:name Medical and Health Sciences
139 rdf:type schema:DefinedTerm
140 anzsrc-for:1117 schema:inDefinedTermSet anzsrc-for:
141 schema:name Public Health and Health Services
142 rdf:type schema:DefinedTerm
143 sg:journal.1049769 schema:issn 2052-0492
144 schema:name Journal of Intensive Care
145 schema:publisher Springer Nature
146 rdf:type schema:Periodical
147 sg:person.013251005701.24 schema:affiliation grid-institutes:grid.410724.4
148 schema:familyName Zhou
149 schema:givenName Jamie Xuelian
150 schema:sameAs https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.013251005701.24
151 rdf:type schema:Person
152 sg:person.015447712161.26 schema:affiliation grid-institutes:grid.163555.1
153 schema:familyName Chai-Lim
154 schema:givenName Crystal
155 schema:sameAs https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.015447712161.26
156 rdf:type schema:Person
157 sg:person.0704526420.08 schema:affiliation grid-institutes:grid.163555.1
158 schema:familyName Phua
159 schema:givenName Ghee Chee
160 schema:sameAs https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.0704526420.08
161 rdf:type schema:Person
162 sg:person.0752666000.97 schema:affiliation grid-institutes:grid.163555.1
163 schema:familyName Anantham
164 schema:givenName Devanand
165 schema:sameAs https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.0752666000.97
166 rdf:type schema:Person
167 sg:pub.10.1007/s00134-015-4098-1 schema:sameAs https://app.dimensions.ai/details/publication/pub.1018177387
168 https://doi.org/10.1007/s00134-015-4098-1
169 rdf:type schema:CreativeWork
170 sg:pub.10.1007/s00134-017-4891-0 schema:sameAs https://app.dimensions.ai/details/publication/pub.1091344285
171 https://doi.org/10.1007/s00134-017-4891-0
172 rdf:type schema:CreativeWork
173 sg:pub.10.1017/cem.2020.358 schema:sameAs https://app.dimensions.ai/details/publication/pub.1126059139
174 https://doi.org/10.1017/cem.2020.358
175 rdf:type schema:CreativeWork
176 sg:pub.10.1186/cc12736 schema:sameAs https://app.dimensions.ai/details/publication/pub.1044011276
177 https://doi.org/10.1186/cc12736
178 rdf:type schema:CreativeWork
179 sg:pub.10.1186/s13613-017-0293-2 schema:sameAs https://app.dimensions.ai/details/publication/pub.1086099795
180 https://doi.org/10.1186/s13613-017-0293-2
181 rdf:type schema:CreativeWork
182 sg:pub.10.1186/s41018-018-0033-8 schema:sameAs https://app.dimensions.ai/details/publication/pub.1103462304
183 https://doi.org/10.1186/s41018-018-0033-8
184 rdf:type schema:CreativeWork
185 grid-institutes:grid.163555.1 schema:alternateName Department of Respiratory and Critical Care Medicine, Singapore General Hospital, Academia Building Level 3, 20 College Road, S169856, Singapore, Singapore
186 Medical Social Services Department, Singapore General Hospital, Singapore, Singapore
187 schema:name Department of Respiratory and Critical Care Medicine, Singapore General Hospital, Academia Building Level 3, 20 College Road, S169856, Singapore, Singapore
188 Duke-NUS Medical School, Singapore, Singapore
189 Medical Social Services Department, Singapore General Hospital, Singapore, Singapore
190 rdf:type schema:Organization
191 grid-institutes:grid.410724.4 schema:alternateName Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
192 schema:name Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
193 Duke-NUS Medical School, Singapore, Singapore
194 rdf:type schema:Organization
 




Preview window. Press ESC to close (or click here)


...