TABLE B-4Possible Indicators for Crisis Capacitya

Situational awareness indicators
 Overall hospital bed availability< 5% available or no available beds for >12 hours< 5%< 5%
 Intensive care unit bed availabilityNone available< 5% regional beds available< 5% state beds available
 Ventilators< 5% available< 5% available< 5% available
 Divert statusOn divert > 12 hours> 50% EDs on divert> 50% EDs on divert
 Emergency medical services call volume2 times usual
 Syndromic predictionsWill exceed capacityWill exceed capacityWill exceed capacity
 Emergency department (ED) wait time> 12 hours
Event-specific indicators
 Illness/injury incidence and severity
 Disaster declaration> 1 area hospital> 2 major hospitals
 Contingency care being provided and unable to rapidly address shortfallAny hospital reportingAny hospital reportingAny hospital reporting
 Resource-specific shortage (e.g., antibiotic, immunoglobulin, oxygen, vaccine)Notification by supplierNotification by hospitalsNotification by hospitals/suppliers
 Outpatient careMarked increase in appointment demand or unable to reach clinic due to call volume
 Staff illness rate> 10%> 10%> 10%
 School AbsenteeismNot applicable> 20%> 20%
 Disruption of facility or community infrastructure and functionUtility or system failure> 1 hospital affected> 5 hospitals affected or critical access hospital affected

The indicators in this table should be developed in relation to usual resources in the area and usage patterns—numbers are examples only.

From: B, Summary of Guidance for Establishing Crisis Standards of Care for Use in Disaster Situations: A Letter Report

Cover of Crisis Standards of Care
Crisis Standards of Care: Summary of a Workshop Series.
Institute of Medicine (US) Forum on Medical and Public Health Preparedness for Catastrophic Events.
Washington (DC): National Academies Press (US); 2010.
Copyright © 2010, National Academy of Sciences.

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