Development of a triage protocol for critical care during an influenza pandemic

Michael D. Christian, Laura Hawryluck, Randy S. Wax, Tim Cook, Neil M. Lazar, Margaret S. Herridge, Matthew P. Muller, Douglas R. Gowans, Wendy Fortier, Frederick M. Burkle

Research output: Contribution to journalArticlepeer-review

220 Scopus citations


Background: The recent outbreaks of avian influenza (H5N1) have placed a renewed emphasis on preparing for an influenza pandemic in humans. Of particular concern in this planning is the allocation of resources, such as ventilators and antiviral medications, which will likely become scarce during a pandemic. Methods: We applied a collaborative process using best evidence, expert panels, stakeholder consultations and ethical principles to develop a triage protocol for prioritizing access to critical care resources, including mechanical ventilation, during a pandemic. Results: The triage protocol uses the Sequential Organ Failure Assessment score and has 4 main components: inclusion criteria, exclusion criteria, minimum qualifications for survival and a prioritization tool. Interpretation: This protocol is intended to provide guidance for making triage decisions during the initial days to weeks of an influenza pandemic if the critical care system becomes overwhelmed. Although we designed this protocol for use during an influenza pandemic, the triage protocol would apply to patients both with and without influenza, since all patients must share a single pool of critical care resources.

Original languageEnglish (US)
Pages (from-to)1377-1381
Number of pages5
JournalCMAJ. Canadian Medical Association Journal
Issue number11
StatePublished - Nov 21 2006
Externally publishedYes

ASJC Scopus subject areas

  • Medicine(all)


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