Table 2.

Highlights of potential contributions from different stakeholders during critical care disaster preparedness efforts

Stakeholder	Potential Contributions to Critical Care Disaster Planning
Critical care physicians	•Develop physician resource plan, including strategies to train and integrate non-ICU physicians into the surged ICU patient care team •Determine procedures for assisting other areas of the hospital (eg, emergency department) during early phases of a disaster before the wave of patients being received by the ICU
Critical care nursing, advanced practice nurses (nurse practitioners, nurse anesthetists), physician assistants, critical care paramedics	•Develop staffing strategies, including integration of non-ICU nursing support into surged ICU patient care team •Identify opportunities to maximize scope of practice and contribution from advanced providers
Respiratory therapists	•Planning for medical gas and ventilatory support equipment, including in nontraditional care areas to manage critically ill patients •Education and practice with nonfamiliar stockpile ventilators
Pharmacists	•Provide advice on appropriate medications to stockpile for all-hazards and hazard-specific plans
Dieticians, physiotherapists, and occupational therapists	•Develop mitigation strategies to maintain adequate nutrition and rehabilitation during surge demand for services •Create just-in-time educational tools to help family members assist with rehabilitation activities
Mental health clinicians, social workers, chaplaincy, and clinical ethicists	•Develop plan for advance stress inoculation for hospital staff •Plan for need to support patients, family members, and hospital staff during and after a disaster
Trauma, emergency department, and perioperative services	•Develop plans for mutual assistance between programs tailored to different phases of a disaster, including need for suspension of elective surgical activity •Ensure mechanisms for transfer of accountability are in place despite surge in patient mobility
Pediatric, neonatal, and obstetric services	•Determine specific equipment and supply needs to support these special patient populations •Anticipate need to support pediatric critical care in nonpediatric hospitals during a disaster event
Laboratory and diagnostic imaging services	•Plan for enhanced point-of-care testing/studies to expedite clinical decision making and reduce demand on overwhelmed staff
Facilities and information technology	•Prepare for modifications to create more negative-pressure airborne isolation space •Ensure adequate and flexible network coverage to allow use of mobile computers in makeshift clinical areas
Security	•Anticipate access control needs for traditional and makeshift critical care clinical areas •Provide support for staff during challenging interactions with family members, particularly during communication of triage decisions
Administration and finance	•Provide support for critical care disaster preparedness activities •Secure external funding when possible to offset the costs of disaster preparedness (eg, medication and equipment stockpiles, staff education)