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The Development of an Evacuation Protocol for Patients with Ventricular Assist Devices During a Disaster

  • Katherine J Davis (a1), Joseph Suyama (a1), Jennifer Lingler (a2) and Michael Beach (a2)
Abstract
Abstract Introduction

Health care providers are on the forefront of delivering care and allocating resources during a disaster; however, very few are adequately trained to respond in these situations. Furthermore, there is a void in the literature regarding the specific care needs of patients with ventricular assist devices (VADs) in a disaster setting. This project aimed to develop an evidenced-based protocol to aid health care providers during the evacuation of patients with VADs during a disaster.

Methods

This is a qualitative study that used expert review, tabletop discussion, and a survey of health care professionals to develop and evaluate an evacuation protocol. The protocol was revised after each stage of review in order to reach a consensus document.

Results

The project concluded with the finalization of a protocol which addresses evacuation and patient triage, and also includes an algorithm to determine which staff members should be evacuated with patients, transportation resources, evacuation documentation, and items patients need during evacuation. The protocol also addressed steps to be taken in the event that evacuation efforts fail and how to manage outpatient VAD patients seeking assistance.

Conclusions

This protocol provides guidance for the care of VAD patients in the event of a disaster and evacuation. Protocols such as this address difficult scenarios and should be created prior to a disaster to assist staff in making difficult decisions. These documents should be created using multi-disciplinary feedback via the consensus model as well as the Institute of Medicine (IOM; National Academy of Medicine; Washington, DC USA) “Crisis Standards of Care.”

Davis KJ , Suyama J , Lingler J , Beach M . The Development of an Evacuation Protocol for Patients with Ventricular Assist Devices During a Disaster. Prehosp Disaster Med. 2017;32(3):333338.

Copyright
Corresponding author
Correspondence: Katherine Davis, DNP, AGACNP-BC Suite 9D 23 200 Lothrop St Pittsburgh, Pennsylvania USA 15213 E-mail: KJD523@gmail.com
Footnotes
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Conflicts of interest: This manuscript was not supported by grant funding. The authors have no disclosures of conflicts of interests.

Footnotes
References
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1. ChildersAK, MayorgaME, TaaffeKM. Prioritization of strategies for patient evacuations. Health Care Manag Sci. 2014;17(1):77-87.
2. AbirM, JanS, JubeltL, MerchantRM, LurieN. The impact of a large-scale power outage on hemodialysis center operations. Prehosp Disaster Med. 2013;28(6):543-546.
3. DowneyEL, AndressK, SchultzCH. External factors impacting hospital evacuations caused by Hurricane Rita: the role of situational awareness. Prehosp Disaster Med. 2013;28(3):264-271.
4. TepermanS. Hurricane Sandy and the greater New York health care system. J Trauma Acute Care Surg. 2013;74(6):1401-1410.
5. JohnstoneM, TuraleS. Nurses’ experiences of ethical preparedness for public health emergencies and health care disasters: a systematic review of qualitative evidence. Nurs Health Sci. 2014;16(1):67-77.
6. RanseJ, HuttonA, JeeawodyB, WilsonR. What are the research needs for the field of disaster nursing? An international Delphi study. Prehosp Disaster Med. 2014;29(5):1-7.
7. TonerE, WaldhornR, FrancoC, et al. Hospitals Rising to the Challenge: The First Five Years of the US Hospital Preparedness Program and Priorities Going Forward. Baltimore, Maryland USA: Center for Biosecurity of UPMC; 2009.
8. DaftaryRK, CruzAT, ReavesEJ, et al. Making disaster care count: consensus formulation of measures of effectiveness for natural disaster acute phase medical response. Prehosp Disaster Med. 2014;29(5):1-7.
9. HammadKS, ArbonP, GebbieK, HuttonA. Nursing in the emergency department (ED) during a disaster: a review of the current literature. Australas Emerg Nurs J. 2013;15(4):235-244.
10. ChristianMD, SprungCL, KingMA, et al. Triage: care of the critically ill and injured during pandemics and disasters: CHEST consensus statement. Chest. 2014;146(4 Suppl):e61S-e74S.
11. Institute of Medicine. Crisis Standards of Care: A Systems Framework for Catastrophic Disaster Response. Washington, DC USA: The National Academies Press; 2012.
12. KleinKR, PepePE, BurkleFM, NagelNE, SwientonRE. Evolving need for alternative triage management in public health emergencies: a Hurricane Katrina case study. Disaster Med Public Health Prep. 2008;2(Suppl 1):S40-S44.
13. California Emergency Medical Services Authority (EMSA). Disaster medical services division- Hospital Incident Command System (HICS). 2007. http://www.emsa.ca.gov/ disaster_medical_services_division_hospital_incident_command_system. Accessed August 8, 2015.
14. Federal Emergency Management Agency (FEMA). National Incident Management System (NIMS). 2011. https://www.fema.gov/national-incident-management-system. Accessed August 8, 2015.
15. Centers for Medicare & Medicaid Services (CMS). Survey and certification: emergency preparedness for every emergency. 2013. http://www.cms.gov/Medicare/Provider-Enrollment-and-certification/SurveyCertEmergPrep/Downloads/SandC_EPChecklist_Provider.pdf. Accessed June 15, 2015.
16. Thoratec Corporation. Duel drive console instructions for use. http://www.thoratec.com/_assets/download-tracker/14025/14025_IFU-VAD-Dual-Drive-Console_revL.pdf. Accessed June 9, 2015.
17. ZaneR, BiddingerP, HassolA, RichT, GerberJ, DeAngelisJ. Hospital evacuation decision guide. (Prepared under Contract No. 290-20-0600-011.) AHRQ Publication No. 10-0009. Rockville, Maryland USA: Agency for Healthcare Research and Quality; 2010.
18. US Department of Health & Human Services, Agency for Healthcare Research and Quality. 2011. Chapter 3. Pre-event evacuation decision guide. http://archive.ahrq.gov/prep/hospevacguide/hospevac3.htm. Accessed June 15, 2014.
19. EspirituM, PatilU, CruzH, et al. Evacuation of a neonatal intensive care unit in a disaster: lessons from Hurricane Sandy. Pediatrics. 2014;134(6):e1662-e1669.
20. FeminoM, YoungS, SmithV. Hospital-based emergency preparedness: evacuation of the neonatal intensive care unit- the smallest and most vulnerable population. Pediatr Emerg Care. 2013;29(1):107-113.
21. SchultzCH, KoenigKL, LewisRJ. Implications of hospital evacuation after the Northridge, California earthquake. N Engl J Med. 2003;348(14):1349-1355.
22. CocanourCS, AllenSJ, MazabobJ, et al. Lessons learned from the evacuation of an urban teaching hospital. Arch Surg. 2002;137(10):1141-1145.
23. SextonKH, AlperinLM, StoboJD. Lessons from Hurricane Rita: the University of Texas Medical Branch Hospital’s evacuation. Acad Med. 2007;82(8):792-796.
24. Institute of Medicine (IOM). Guidelines for Establishing Crisis Standards of Care for Use in Disaster Situations: A Letter Report. Washington, DC USA: National Academies Press; 2009.
25. University of Pittsburgh Medical Center (UPMC). Decision algorithm: who should transport the VAD patient? 2011. http://www.upmc.com/. Accessed June 15, 2014.
26. HickJL, KoenigKL, BarbischD, BeyTA. Surge capacity concepts for health care facilities: the CO-S-TR model for initial incident assessment. Disaster Med Public Health Prep. 2008;2(Suppl.1):S51-S57.
27. KingMA, DorfmanMV, EinavS, NivenAS, KissoonN, GrissomCK. Evacuation of intensive care units during disaster: learning from the Hurricane Sandy experience. Disaster Med Public Health Prep. 2016;10(1):20-27.
28. EschunGM, JacobsohnE, RobertsD, Sneiderman. Ethical and practical considerations of withdrawal of treatment in the intensive care unit. Can J Anaesth. 1999;45(5):497-504.
29. Society of Critical Care Medicine Ethics Committee. Attitudes of critical care medicine professionals concerning distribution of intensive care resources. Crit Care Med. 1994;22:358-362.
30. BaackS, AlfredD. Nurses’ preparedness and perceived competence in managing disasters. J Nurs Scholarsh. 2013;45(3):281-287.
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Prehospital and Disaster Medicine
  • ISSN: 1049-023X
  • EISSN: 1945-1938
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