Five Days at Memorial: Life and Death in a Storm-Ravaged Hospital

by Sheri Fink

However, mounting evidence suggests that the plans would not accurately direct care to patients who are most likely to survive with treatment, as is often presumed. Several researchers have studied how groups of ICU patients might fare under these emergency protocols. They asked doctors to categorize the patients in their ICUs during the relatively mild H1N1 “swine flu” pandemic as if it were an emergency and they needed to ration. The results were disturbing. The majority of patients who would have been tagged as “expectant” (i.e., likely to die or unable to be saved with the resources available; analogous to Memorial’s “category 3”) and been designated for withdrawal of ICU care and ventilator support in fact actually survived with continued treatment and were discharged from the hospital. In some cases, their ventilators would likely have been reassigned to a group of patients whose survival rate turned out to be lower. Even with clear guidelines to follow, triage officers often disagreed and lacked confidence in their categorization decisions.

Very interesting