Richard Waldhorn

A conceptual approach to improving care in pandemics and beyond: Severe lung injury centers

The events of the 2009 influenza pandemic sparked discussion regarding the need to optimize delivery of care to those most severely ill. We propose in this conceptual study that a tiered regionalization care system be instituted for patients with severe acute respiratory distress syndrome. Such system would be a component of national pandemic plans and could also be used in day-to-day operations.

Survey of mechanical ventilators in US acute care hospitals: a baseline for critical care surge capacity planning.

The study by Rubinson et al reported in this issue of Disaster Medicine and Public Health Preparedness estimating the number and distribution of mechanical ventilators in the United States has been much anticipated and is important to emergency preparedness.1 It is surprising to many that this information was not previously known, but, in fact, no attempt to comprehensively count and characterize the ventilators in the United States had ever been attempted. Previous estimates of the total number differed by a factor of 2, from approximately 50 000 to approximately 100 000. The critical importance of this information became apparent following the terrorist attacks of September 11, 2001, and the 2001 anthrax attacks as federal planners began to consider the number of ventilators needed in the Strategic National Stockpile (SNS). Before one can make an informed judgment about how many additional ventilators may be needed in a disaster, an inventory of the existing supply is needed.