Arizona heads for triage...

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...Patients would be given scores based on a range of criteria and ranked for highest, intermediate and lowest priority for critical care resources. Those initial scores would be based on years the individual may live after treatment and underlying conditions.

Then, if two or more patients need one resource, these additional factors may be considered as priorities, in the following order:

Pediatric patients under the age of 18.
First responders or frontline health care workers.
Single caretakers for minors or dependent adults.
Pregnant women.
Younger individuals.

Triage scores would be recalculated daily for hospitalized patients based on their condition, according to the plan.

An update sent Friday to members of the Arizona Hospital and Healthcare Association said the State Disaster Medical Advisory Committee met to discuss activating contingency and crisis standards of care. When the committee is activated for a disaster response, it serves as the statewide policy group for the Health Emergency Operating Center, which is managed by the state health department.

“After much discussion, the committee agreed that most, if not all, hospitals are currently operating under crisis standards of care and recommended that the Arizona Department of Health Services declare this to be the case,” the association’s update said.

“Moving to crisis standards of care will allow consideration of regulatory waivers as well as additional liability protections. A decision on activation is expected to be made within the next few days.”

Will Humble, the executive director of the Arizona Public Health Association and a former director of the state health department, said officially activating these standards would protect hospitals from liability while acknowledging that the state’s hospitals are at this point of needing such protection because they need to triage patients.

“It's the only time that this has happened in my lifetime. I mean they used it in Vietnam, and they use it in war. But for civilian purposes, I can't think of a time when this has been implemented,” Humble said.

Most doctors and health care providers don’t expect that this is how they will have to treat patients at any time, unless perhaps they are front-line military providers, he said.

Humble recalled times, such as during H1N1, when hospitals were given some regulatory reliefs or waivers of parts of the administrative code.

“I think it's really important for everybody to know about this," Humble said. "It's the reality. It's what's coming. And it's a result of the decisions that have been made. This isn't bad luck.”

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