This article reports on the release of new crisis standards of care (CSC) guidelines by Colorado state health officials that address allocation of scarce resources if necessary during a public health emergency.
Under the guidelines, hospitals would make decisions on patient triage for receiving scarce resources, such as ventilators, using four-member triage teams. The teams would include an ethics or palliative care expert, a critical care physician, a nurse, and a hospital leader, separating this decision-making from the work of a patient’s bedside caregiver team.
The guidelines call for triage teams to rank patients using a tiered approach. The first tier is based on symptom severity, chronic illness, and likelihood of near-term survival with intervention. For patients who rank equally, second tier priority would be given to children, health care workers, and first responders. For patients still ranked equally, third tier priority would consider pregnancy, status as a sole caregiver to a child or elderly family member, and maximizing total life years saved. For patient remaining tied, the fourth tier would use a random lottery to determine allocation.
The full Colorado guidelines are available here.