Florida plan advises hospitals to bar some patients in event of severe flu pandemic

[I AM NOT THAT GUY 5,715]

Outbreak would limit some hospital care

Florida health officials are drawing up guidelines that recommend barring patients with incurable cancer, end-stage multiple sclerosis and other conditions from being admitted to hospitals if the state is overwhelmed by flu cases.

The plan, which would guide Florida hospitals on how to ration scarce medical care during a severe flu outbreak, also calls for doctors to remove patients with poor prognoses from ventilators to treat those who have better chances of surviving. That decision would be made by the hospital.

The flu causes severe respiratory illnesses in a small percentage of cases, and patients who need ventilators and are deprived of them could die without the breathing assistance the machines provide.

In June, Florida Surgeon General Ana M. Viamonte Ros sent the draft guidelines — which had already undergone a series of internal revisions — to 16 state medical organizations for their feedback.

But the state has not yet publicized the guidelines or solicited input from the general public. The Florida Department of Health released a copy of the draft plan at the request of ProPublica, a nonprofit news organization, which provided it to the Sun Sentinel.

The document addresses one of the most heart-rending issues in medicine: What to do if the number of people in need of ventilators and other treatment dramatically exceeds what is available.

The goal, the plan says, is to focus care on patients whose lives could be saved and who would be most likely to improve. While it says those decisions are not to be made based on patients' perceived social worth or role, the plan calls for different rules for some populations.

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The Florida plan also calls for intensive care unit patients and those using ventilators to be reassessed after 48 to 72 hours.

Those whose chances of survival have significantly worsened would be taken off the machines or discharged from critical care to make way for others who may have a better chance of survival. If needed, they would be given palliative care to keep them comfortable.

One goal of Florida's plan is to "reduce or eliminate" the legal liability of health care workers who, in good faith, deny or withdraw treatment from some patients in an emergency. The plan includes sample executive orders that the governor could issue to shield workers and authorize hospitals to implement the guidelines.

The draft document also outlines how the health care system should stretch critical resources before moving to ration care.

The guidelines suggest reusing supplies, canceling surgeries that are not absolutely necessary, training staff to perform additional tasks and drawing on stockpiles. The general public's responsibilities include treating certain sick family members at home and monitoring public health messages.

Florida's draft guidelines aim to provide the "greatest good for the greatest number" when doing the best for all patients is no longer possible.

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http://www.sun-sentinel.com/news/nationwor...7387,full.story

[ScottThuy 140]

I was really pissed that we caught it last month when there was an outbreak at my sons school... I guess its a good thing since we have a low probability of catching it again.... Our county looks like it will be death with a slight chance of hospitals...

[Mr. Big Dog 10,747]

Pre Obama-care health care rationing in a GOP run state in the country with the best health care system in the world? Say it isn't so.

[I AM NOT THAT GUY 5,715]

Pre Obama-care health care rationing in a GOP run state in the country with the best health care system in the world? Say it isn't so.

Triage. Something I don't think the general population is ready for, although it is planned for and trained for to some degree, in most locations. Florida is probably ahead of the curve, as are most Gulf states in general. California gets plenty of practice on a yearly basis, although they have dodged the really big bullet many times, for the situation that would completely overwhelm their emergency response capability, like New Orleans during Katrina. FEMA should just stay home. We will call you if and when we need your money.

Edited October 19, 2009 by Lone Ranger