UPMC develops 8-point system to allocate scarce ventilators

The University of Pittsburgh Medical Center developed a strategy for hospitals to ethically allocate ventilators to patients when faced with shortages, Stat reported. 

Some states have issued guidance for hospitals on how to choose which patients receive ventilators or intensive care that exclude large groups of patients, such as those with late-stage cancer or Alzheimer's disease. Such guidelines have sparked criticism and a federal civil rights investigation, according to The New York Times

The guidelines from UPMC score patients on an eight-point scale that doesn't automatically exclude any patient group, according to Stat

The first four points on the scale are determined based on how likely it is a patient will die before going home. One way to assess that is by using the patient's SOFA score, or sequential organ failure assessment score, which is calculated based on factors such as how much oxygen a patient is taking in and their blood platelet count. 

The next four points are determined based on whether patients have certain conditions that tend to decrease odds of long-term survival, such as late-stage heart failure or end-stage renal disease. 

A lower score means a patient gets higher prioritization to receive intensive care, according to Stat. If there's a tie, UPMC's guidelines prioritize younger people and front-line healthcare workers. It treats all healthcare workers equally, including physicians, nurses, respiratory therapists and members of maintenance staff that clean hospital rooms. 

The guidelines don't prioritize people with young children over those that don't have children. 

"This is a framework that is grounded in medical principles of survival, with no judgment of whether one’s broad social worth, with no inclusion of consideration of individuals’ perceived social worth," Douglas White, MD, a UPMC critical care physician who helped develop the guidelines told Stat

The framework says a triage committee of physicians who are not on the front lines must assess the scores and make decisions about which patients get critical care. The policy is designed to avoid conflicts of interest or favoritism if bedside physicians have to make decisions for their own patients.

The state of Pennsylvania is expected to endorse the framework for all hospitals in the state, according to Stat, and several other states are considering it. 

Several hundred hospitals are either adopting or considering UPMC's guidelines, including Yale, Pennsylvania State University and Kaiser Permanente. 

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