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Research ArticleConference Proceedings

Mechanical Ventilation in Mass Casualty Scenarios. Augmenting Staff: Project XTREME

Michael E Hanley and Gregory M Bogdan
Respiratory Care February 2008, 53 (2) 176-189;
Michael E Hanley
Division of Pulmonary and Critical Care Medicine at Denver Health Medical Center and the University of Colorado Health Sciences Center, Denver, Colorado
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  • For correspondence: [email protected]
Gregory M Bogdan
Rocky Mountain Poison and Drug Center, and with Pharmaceutical Sciences, University of Colorado Health Sciences Center, Denver, Colorado
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Abstract

Disaster preparedness typically includes plans that address the need for surge capacity to manage mass-casualty events. A major concern of disaster preparedness in respiratory therapy focuses on responding to a sudden increase in the volume of patients who require mechanical ventilation. Plans for such disasters must include contingencies to address surge capacity in ventilator inventories and the respiratory therapy staff who will manage the ventilators. Tactics to address these situations include efforts to lower demand by transferring patients to other institutions as well as efforts to augment staffing levels. Staff can be augmented by mobilization of deployable teams of volunteers from outside the region and through exploitation of local resources. The latter includes strategies to recruit local respiratory therapists who are currently in either non-clinical or non-hospital-based positions and policies that optimize existing respiratory therapy resources within an institution by canceling elective surgeries, altering shift structure, and postponing vacations. An alternative approach would employ non-respiratory-therapy staff to assist in the management of patients with respiratory failure. Project XTREME (Cross-Training Respiratory Extenders for Medical Emergencies) is a cross-training program developed to facilitate training of non-respiratory-therapy health professionals to assist in the management of patients who require mechanical ventilation. It includes an interactive digital video disc as well as a competency validation laboratory and is designed to be performed at the time of an emergency. Pilot testing of the program suggests it is effective.

  • disaster
  • mass casualty
  • respiratory therapist
  • mechanical ventilation
  • ventilator
  • cross-training

Footnotes

  • Correspondence: Michael E Hanley MD, Division of Pulmonary and Critical Care Medicine, 660 Bannock 4000, Denver CO 80204. E-mail: mhanley{at}dhha.org.
  • Dr Hanley presented a version of this paper at the 40th Respiratory Care Journal Conference, “Mechanical Ventilation in Mass Casualty Scenarios,” held July 16–17, 2007, in Reno, Nevada.

  • Copyright © 2008 by Daedalus Enterprises Inc.
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Respiratory Care: 53 (2)
Respiratory Care
Vol. 53, Issue 2
1 Feb 2008
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Mechanical Ventilation in Mass Casualty Scenarios. Augmenting Staff: Project XTREME
Michael E Hanley, Gregory M Bogdan
Respiratory Care Feb 2008, 53 (2) 176-189;

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Mechanical Ventilation in Mass Casualty Scenarios. Augmenting Staff: Project XTREME
Michael E Hanley, Gregory M Bogdan
Respiratory Care Feb 2008, 53 (2) 176-189;
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Keywords

  • disaster
  • mass casualty
  • respiratory therapist
  • mechanical ventilation
  • ventilator
  • cross-training

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