Practical considerations of implementing disaster crisis standards of care in the intensive care unit: A scoping review

Disasters have the potential to cause a surge of patients, some of which may require admission to an intensive care unit. Due to the high resource requirements of intensive care units, standards of care may need to be altered during a disaster to treat more people with limited resources, a care model referred to as ‘crisis standards of care’. The aim of this scoping review was to explore the practical considerations of implementing crisis standards of care in intensive care units during patient surges resulting from disasters. Guided by the Joanna Briggs Institute methodology, most of the 19 studies included in this review were qualitative in design, undertaken in developed countries and focused on COVID-19. Adequate space, human resources, and physical resources were required for standard patient care in ICUs. When unbalanced, contingency measures or crisis standards of care were implemented, and adjustment to ICU governance was required. During times of crisis standards of care implementation, healthcare practitioner wellbeing was impacted. Continued efforts to support the ICU workforce before, during and after a disaster are warranted. •Adequate space, human resources and physical resources are required for ICU care.•In a crisis, ICU governance adjustments support challenging and complex decisions.•During times of crisis, healthcare practitioner wellbeing can be impacted.•Continued efforts to support the ICU workforce throughout a disaster are needed.