Mass Triage

Scenario You are the director of a small community hospital emergency department (the only one for miles). Early one morning, without warning, a violent earthquake strikes your community. For 90 seconds buildings sway and crumble, water shoots out of broken water mains, and electric power is out everywhere.

Highways and main streets are blocked by debris, with most forms of communication down. Railroad and airport runways are damaged. The number of injured and dead is quickly rising. There will be no way to mass evacuate all these casualties.

Around 12 hours later your hospital is caring for earthquake victims, but also other serious but unrelated health issues. Many victims were employees of your hospital and are injured or unable to physically get into the facility to help. Everyone is stretched to the limit and critical medical supplies are running out. It will be some time before state and federal aid arrives.

The hospital has nine critically injured patients but only enough supplies and staff to treat five of them. The four who do not receive treatment probably will die before more help arrives. The patients break down as follows:
Patient Ages Chance of Survival with Treatment
A, B, C 2/35/80 Low (10%)
D, E, F 11/55/75 Medium (60%)
G, H, I 8/25/85 High (80-90%)

Answer each of the following questions on the Discussion Board. All answers and replies should be substantive. Back up all positions/opinions with credible peer-reviewed literature research.

  1. In your first post, answer each of the following questions:
    Which 5 patients did you select to receive treatment (remember, the remainder will die).
    What were the main reasons behind your decisions? Consider: age, chance of survival, and any other factors you would like to consider.
    When you can’t save everyone, what matters most?
    What values or goals are most important? Consider: first-come, first-served; “lottery” system; spreading resources to save the greatest number; or some other criteria).
    Why is the system you selected the most fair?
    Remember, although this is opinion-based, you must use credible research to defend your decision making.
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