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Objective <p>This study explored experiences and opinions of Australian intensivists working during Coronavirus disease 2019 (COVID-19) regarding triage in disaster scenarios and their views on the role of guidelines.</p> Design, setting, participants <p>An online questionnaire, adapted from a European study, was distributed to Australian intensivists in 2023. Participants were College of Intensive Care Medicine of Australia and New Zealand (CICM) trainees and consultants working in Australia during the COVID-19 pandemic.</p> Main outcome measure <p>We examined the respondents’ preferred grounds and considerations of Intensive Care Unit (ICU) triage in five case scenarios, exploring ventilator allocation decisions, consulting others and extreme expansion of ICU capacity. Preferences were examined using a five-point Likert scale and in free-text responses. We performed group comparisons based on age, gender, seniority. Secondary outcomes included exploring feelings of moral distress and opinions on guidelines.</p> Results <p>Among the 32 survey respondents, most favoured prioritising ventilation of younger patients, aligning generally with utilitarian principles, except in the case of active ventilator reallocation from an existing patient. Most respondents would consult colleagues in all decisions. However, males and consultants (compared to females and trainees) were less likely to involve clinical ethics committees in decision-making. Less than half (47%) of respondents said that they felt adequately supported during the COVID-19 pandemic, with a majority (59%) agreeing that publicly available triage guidelines would help reduce moral distress when making these decisions in the future.</p> Conclusions <p>There is general support for clearer triage guidelines to be provided to intensivists in disaster scenarios. However, given the small sample size of this study and disagreements on several core triaging principles, more research is needed to adequately reach consensus in this area.</p>

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A national survey of Australian intensivists’ opinions and experiences of triage during the COVID-19 pandemic

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年7月9日

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  • Eric Smith,
  • Will Cairns,
  • Rebecca Evans,
  • Lynn Woodward

摘要

Objective

This study explored experiences and opinions of Australian intensivists working during Coronavirus disease 2019 (COVID-19) regarding triage in disaster scenarios and their views on the role of guidelines.

Design, setting, participants

An online questionnaire, adapted from a European study, was distributed to Australian intensivists in 2023. Participants were College of Intensive Care Medicine of Australia and New Zealand (CICM) trainees and consultants working in Australia during the COVID-19 pandemic.

Main outcome measure

We examined the respondents’ preferred grounds and considerations of Intensive Care Unit (ICU) triage in five case scenarios, exploring ventilator allocation decisions, consulting others and extreme expansion of ICU capacity. Preferences were examined using a five-point Likert scale and in free-text responses. We performed group comparisons based on age, gender, seniority. Secondary outcomes included exploring feelings of moral distress and opinions on guidelines.

Results

Among the 32 survey respondents, most favoured prioritising ventilation of younger patients, aligning generally with utilitarian principles, except in the case of active ventilator reallocation from an existing patient. Most respondents would consult colleagues in all decisions. However, males and consultants (compared to females and trainees) were less likely to involve clinical ethics committees in decision-making. Less than half (47%) of respondents said that they felt adequately supported during the COVID-19 pandemic, with a majority (59%) agreeing that publicly available triage guidelines would help reduce moral distress when making these decisions in the future.

Conclusions

There is general support for clearer triage guidelines to be provided to intensivists in disaster scenarios. However, given the small sample size of this study and disagreements on several core triaging principles, more research is needed to adequately reach consensus in this area.