Flu epidemic...who gets treatment?

[CoolhandHutch, MSN, RN]

Be practical in your replies. If the "Big One" hits, who gets treated? Do we prohibit LTC/Memory care facilities from sending patients into the ER? Is it first-come, first-served? Where do we use the resources?

I've heard as many as 80% of acute care providers (nurses, midlevels, and physicians) will not be 'available' (sick or otherwise) for an epidemic thus constricting resources.

[NursingAgainstdaOdds]

I really don't think entire facilities would be barred from sending patients to the ED. The protocols I've seen look at the individual patient. NYS has an extensive plan of action for Pandemic Influenza. They have priority lists for vaccines and for anti-viral medication treatments. For vaccination, vaccine manufacturers and healthcare workers are at the top of the list of prioritization. After that comes individuals greater than 65 years of age with one or more high risk conditions for influenza. For antiviral medication prioritization, patients admitted to the hospital are at the top of the list, followed by healthcare workers.

[lpnflorida]

In regards to patient in LTC.I think the key might be in the nurses ability to recognize the symptoms early and receiving orders for Tamflu. ( pardon if mis spelt ). That of course will depend on the proactivty of your employer as to having a stock of the drug if needed.

I have not heard in our facility that anything beyond first come first served in our Hospital. Healthcare workers will have access to vaccinations, is my understanding.

[mama_d, BSN, RN]

I think that treatment/prevention for healthcare workers and their immediate family would be priority...make it more likely that we would come in to take care of the sick patients if we don't have to care for sick family. I know it's not necessarily ethical, but you can bet your bippy that my kidlets and hubby take priority over my patients; if they're sick, I'm staying home to care for them.

As far as other demographics go, it seems that those at highest risk for extended hospitalizations should have prevention first...yeah, the 85 yo demented old lady in a LTC setting might not seem like high priority, but given the fact that with the likely comorbities she possesses would lead to a longer hospital stay, not to mention all the other residents she'd infect, I'd rather have her get preventative treatments instead of tying up a bed for longer than an otherwise healthy 40 yo would. It seems like it would be a better allocation of resources in the long run to offer preventative measures to someone who would likely end up with a longer hospital stay.

Hope that made some kind of sense, not sure how to explain it better.

[HonestRN]

I think that treatment/prevention for healthcare workers and their immediate family would be priority...make it more likely that we would come in to take care of the sick patients if we don't have to care for sick family. I know it's not necessarily ethical

I agree that health care workers should be top priority since they will be the ones to take care of everyone else so therefore I don't see an ethics issue at all.

[lpnflorida]

I see where the New York versions put direct care healthcare workers as a priority to receive vaccine. It did not put their families into that group. However that would not mean you would not make every attempt to see they are vaccinated by their own physcians. I worked with an RN who had her doctor 2 years ago prescribe tamiflu, she ordered enough of the drug for her family members from Canada I believe, she keeps it on stock just in case of shortage.

[CHATSDALE]

a few years ago when there was a severe shortage of vaccine d/t to a contamination in one plant, health care workers were often the only ones to get the vaccine

if we had a pandemic on our hands some really tough decisions would have to be made

[classicdame, MSN, EdD]

In the disaster course I took they taught us an ACCEPTED triage practice that will identify patients who can/cannot be helped. Basically, the healthier you are the better chance you have of getting help. With minimal resources tough decisions have to be made.