Abstract
SARS-CoV-2 has caused a global pandemic unprecedented in size, spread, severity, and mortality. The influx of patients with severe or life-threatening disease means that in some cases, the available medical resources are not sufficient to meet the needs of all patients. Hence, healthcare providers may be forced to make difficult choices about which patients should be referred to the ICU. This document is intended to provide conceptual support to all healthcare teams currently engaged in the frontline management of the COVID-19 pandemic. It aims to assist physicians in the decision-making process for ICU admission and to help them provide uninterrupted and high-quality care.
Highlights
This document was written at the request of the Parisarea healthcare authorities in France
This guidance intended to help professionals coordinate patients’ pathways and standardize practices among centers to avoid acting on a first-come first-served basis. These recommendations will evolve as knowledge about COVID-19 increases
The review from Joebges and Andorno [5] provided a multinational perspective on the ethics guidelines on COVID-19 triage
Summary
This document was written at the request of the Parisarea healthcare authorities in France. This document is intended to provide conceptual support to all healthcare teams currently engaged in the frontline management of the COVID-19 pandemic It targets physicians whose culture, training, and/or experience may not have prepared them to the reflection underlying the treatment-limitation decision-making process. – Neurological: Glasgow Coma Scale score < 12 – Worsening of organ dysfunction – Possible use of the SOFA score – Assessment of the patient’s comfort: pain, anxiety, agitation, dyspnea, congestion, asphyxiation, and isolation – A full commitment to providing support and care for all, in a way that respects the patient’s dignity In this context of uncertainty, these decision-making principles apply to both COVID and non-COVID patients. In practice The decision-making process involves (see the algorithm below; Fig. 2) the following: 1. Anticipation, as soon as the initial clinical evaluation is carried out, that ICU admission may be required
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