Preparation, Microcosm & Augmentation of Critical Care Capacity Flashcards Preview

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Flashcards in Preparation, Microcosm & Augmentation of Critical Care Capacity Deck (22):

What is a Disaster?

Any event that results in a precipitous or gradual decline in the overall health status of a community with which it is unable to cope adequately.


Categories of Disasters


Examples World Wide

  • Wind Storms 31%
  • Floods 34%
  • Droughts 9%
  • Earthquakes 10%
  • Extreme Temperatures 4%
  • Wild Fires 4%
  • Wave Surges < 1%


What is the Canadian Disaster Database?

The Canadian Disaster Database (CDD) contains detailed disaster information on more than 1000 natural, technological and conflict events (excluding war) that have happened since 1900 at home or abroad and that have directly affected Canadians.


What is the Criteria for the Canadian Disaster Database?

The CDD tracks "significant disaster events" which conform to the Emergency Management Framework for Canada definition of a "disaster" and meet one or more of the following criteria:

  • 10 or more people killed
  • 100 or more people affected/injured/infected/evacuated or homeless
  • an appeal for national/international assistance
  • historical significance
  • significant damage/interruption of normal processes such that the community affected cannot recover on its own


List examples of Natural Occuring Outbreaks of Disease

  • Severe Acute Respiratory Syndrome
  • Lassa Fever
  • H5N1
  • Ebola


What Disasters should we be prepared to manage?

  • Chemical
  • Biological (Intentional or unintentional) Disease outbreaks
  • Radiological & Nuclear
  • Explosive


What are "three categories" of patients treated in the ICU?


Need for EMAT to provide ICU capabilities

  1. Patients that need immediate interventions because of risk of death or serious morbidity
  2. Patients who require intensive monitoring to evaluate their need for potential interventions
  3. Patients who have chronic critical illnesses requiring complex care that is difficult to provide outside the ICU


Critical Care Medicine focuses on the following:

  • Supportive interventions for failing organs
  • Disease-specific therapies
  • Advanced patient monitoring
  • Minimization of adverse consequences


What is the usual ICU survival rate for ARDS?

40 - 65%


What is the usual ICU survival rate for severe sepsis?



What is the usual ICU survival rate for septic shock?



In Disaster Situations why are patients who require critical care likely to die?

  • Patients unable to receive mechanical ventilation and/or hemodynamic support are likely to die during disaster situations.


What is the ICU rate of occupancy in Ontario?



What is Critical Care Surge Capacity Management?

  • Surge capacity managment incorporates standardized guidelines to manage minor, moderate and major surges. Access to critical care services cannot be ensured if patietn volumes exceed the critical care bed capacity.
  • Alternative measures must be coordinated within organizations and the regional LHIN system.


Minor Surge



  • An acute increase in demand for critical care services, up to 15% beyond the normal capacity (>100% and < 115%), where response is localized to an individual hospital.
  • A Minor Surge could result in unplanned admissions from the OR, deteriorating patients on the ward, or going into a minor surge state for the purpose of accepting life or limb threatened patients from a referring hospital


Moderate Surge

  • A larger increase (> 115%) in demand for critical care services that impacts on a LHIN level, where an organized response at the LHIN/regional network level is required.
  • Occurs when a hopsital in Minor Surge is no longer able to maintain services and needs to rely on the resources of other hospitals to assist with managing the surge.
  • A Minor surge could also result from a single event (infectious or casualty) requiring response of several hospitals.


Major Surge

  • An unusally high increase in demand that overwhelms the health care resources of individual hospitals and regions for an extended period of time, where an organized resonse at the provincial or national level is required.


What is All Hazards preparedness?

  • Preparing a response for unforeseen disasters 


What are the four disaster phases?

  • Mitigation
  • Preparedness/Planning
  • Response
  • Recover


What does it mean to be prepared?


What are the 3 most commonly identified components of surge capacity?

  • Staff
  • Stuff (equipment, supplies and pharmaceuticals)
  • Space (room to accomodate patients, providers and equipment)


A fourth component "Structure" (delineation of management infrastructure)