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Record W2106595315 · doi:10.1177/0885066608318457

Intensive Care Unit Disaster Preparation: Keep it Simple

2008· letter· en· W2106595315 on OpenAlexaboutno aff
James Geiling

Bibliographic record

VenueJournal of Intensive Care Medicine · 2008
Typeletter
Languageen
FieldHealth Professions
TopicDisaster Response and Management
Canadian institutionsnot available
FundersInova Health SystemDartmouth College
KeywordsMedicineIntensive care unitSimple (philosophy)Medical emergencyIntensive care medicine

Abstract

fetched live from OpenAlex

Stuff. The ICUs are frequently strapped to provide necessary equipment for day-to-day operations. The sine qua non of critical care “stuff” is the mechanical ventilator. Most ICUs purchase or lease these to care for their usual patient needs. The number of available machines depends on the setting. Kaji and Rubinson found that 71% of hospitals in Los Angeles had less than 6 ventilators available for emergency use. Ontario reports having 16 ventilators/100 000 population. Challenges to surging these machines occur, in part, because vendors often have working supply relationships with multiple customers. Support from the Strategic National Stockpile can provide additional ventilators within 12 hours, providing states and transportation systems can deliver them to the affected facilities. However, it is important to note that in all of the planning for the delivery of emergency mass critical care with mechanical ventilation, no national support plans at present include the provision of medical gas, including oxygen. In this issue of the Journal of Intensive Care Medicine, Mahoney, Biffl, and Cioffi outline an ambitious plan for intensive care units (ICUs) to prepare for mass casualty incidents (MCIs). The journal’s dedication of article space to this topic should be applauded, for modern health care systems with expanding critical care services have insufficient specialized staff, medical equipment, and ICU space to provide standard critical care for the influx of additional patients from a disaster. Therefore, disaster planning, which has typically been under the purview of emergency medicine or more recently, public health disciplines, must transcend into critical care medicine. Additionally, the recent severe acute respiratory syndrome (SARS) epidemic and the looming threat of an influenza pandemic have stimulated much recent debate about how to care for a surge of critically ill who overwhelm ICUs beyond that normally seen in suddenimpact disasters. Therefore, intensivists and the health care systems in which they operate must heed the advice provided in the accompanying article and elsewhere to best prepare for an inevitable surge in critical care requirements. Although the accompanying article develops a methodology for developing a detailed disaster plan for ICUs, I think the planning process needs to consider Murphy’s Law as perhaps an alternative strategy in many ways.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.000
metaresearch head score (Gemma)0.007
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesMeta-epidemiology (narrow), Research integrity, Insufficient payload (model declined to judge)
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Not applicable · Consensus signal: Not applicable
GenreCandidate signal: Commentary · Consensus signal: Commentary
Teacher disagreement score0.245
Threshold uncertainty score1.000

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0000.007
Meta-epidemiology (narrow)0.0010.000
Meta-epidemiology (broad)0.0020.000
Bibliometrics0.0010.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0010.000
Research integrity0.0010.006
Insufficient payload (model declined to judge)0.0020.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.102
GPT teacher head0.440
Teacher spread0.337 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

Study designNot applicable
Domainnot available
GenreCommentary

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations3
Published2008
Admission routes1
Has abstractyes

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