GermAware

Would you be ready if an Avian Flu pandemic hit your area?  Even if you aren't, doctors have begun to plan and one of the questions they need to address is who do they even try to save.  Despite your own personal opinions regarding the value of every human life, know this, doctors will have a much more pragmatic view in the event of a pandemic.

Just in case you were wondering, several respected and influential groups were involved in a recent study that appeared in the May edition of Chest, the medical journal for the American College of Chest Physicians.  The team involved included the CDC, Department of Health and Human Services and Homeland Security.  These groups are attempting to make a concerted effort to get everyone on the same page regarding who deserves medical attention during a disaster.

From a practical standpoint, should a large scale catastrophic event occur, such as the Avian Flu, many resources are fixed and need to be rationed.  These include medical staff, equipment such as ventilators and of course medicine according study's authors.

"If a mass casualty critical care event were to occur tomorrow, many people with clinical conditions that are survivable under usual health care system conditions may have to forgo life-sustaining interventions owing to deficiencies in supply or staffing,'' the report states.

Who Decides 

The study recommends that each hospital should appoint a triage team that is empowered to make the ultimate choice: who should be saved and who should be left to die.  The general guidelines for those not receiving attention include individuals likely to die even with care and unlikely to survive long-term.

In addition, the report produced very specific decision points that are more concrete:

• People older than 85
• Those with severe trauma, which could include critical injuries from car crashes and shootings.
• Severely burned patients older than 60.
• Those with severe mental impairment, which could include advanced Alzheimer's disease.
• Those with a severe chronic disease, such as heart failure, lung disease or poorly controlled diabetes.

Granted, the above items are only recommendations, however it is likely that many hospitals and other critical care facilities will seriously consider them when preparing their own pandemic plans.  Doctors and the health care establishment will certainly have an enormous responsibility in making these very real life and death decisions.  A slippery slope will need to be traversed that will have dire consequences for many.

Certainly the debate will continue, especially with any guidelines that include age.  Should someone that is 85 years and one day old be left in the cold simply because of their birthday?  Because a person has had the unfortunate fate of being stricken with chronic disease, medical care should be denied?  These questions will eventually need answered, however rest assured the outcome will be contentious.

Obviously the ideal solution for everyone on a personal level is to remain healthy.  Even remaining GermAware when faced with a pandemic like the Avian Flu may not be enough.  Take the time to remain educated, healthy and prepared.  It may make a difference for you, your family and friends.

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