scholarly journals Clinical and Ethical Considerations in Allocation of Ventilators in an Influenza Pandemic or Other Public Health Disaster: A Comparison of the 2007 and 2015 New York State Ventilator Allocation Guidelines

2020 ◽  
pp. 1-10
Author(s):  
Susie A. Han ◽  
Valerie Gutmann Koch
Keyword(s):  
New York ◽  
Clinical Data ◽  
Task Force ◽  
Influenza Pandemic ◽  
New York State ◽  
Evidence Based ◽  
Ethical Considerations ◽  
Term Survival ◽  
York State ◽  
Triage Protocol

ABSTRACT Objectives: During an influenza or coronavirus disease 2019 (COVID-19) pandemic that results in acute respiratory distress, the number of available ventilators will not meet demand. In 2007, the New York State Task Force on Life and the Law and Department of Health released draft Guidelines for ethical allocation of ventilators for adults. In 2015, updated guidelines were released to ensure that: (1) revisions reflect the public’s values and (2) the triage protocol is substantiated by evidence-based clinical data. We summarize the development and content of the 2015 Guidelines compared with the 2007 version, emphasizing new/revised aspects of the ethical considerations and clinical protocol. Methods: We compared the 2007 and 2015 guidelines, with particular emphasis on the ethical issues and clinical protocols. Results: The 2015 Guidelines retained much of the ethical and clinical framework of the 2007 draft. The triage protocol was revised using evidence-based clinical data. Patients with the highest likelihood of short-term survival with ventilator therapy have priority access. Protocol consists of exclusion criteria, the sequential organ failure assessment (SOFA) score, and periodic clinical assessments. Guidance is provided on secondary triage criteria. Other forms of medical intervention/palliative care and review of triage decisions are discussed. Conclusions: The 2015 Guidelines reflect advances in medicine and societal values and provide an evidenced-based framework to save the most lives. The framework could be adapted in other emergencies, such as the COVID-19 pandemic, that require ventilators.

Comparing the Incidence and Clinical Data for Simultaneous Bilateral Versus Unilateral Total Hip Arthroplasty in New York State Between 1990 and 2010

2015 ◽  
Vol 30 (11) ◽  
pp. 1887-1891 ◽  
Author(s):  
Sergio A. Glait ◽  
Omar N. Khatib ◽  
Ankit Bansal ◽  
Jason P. Hochfelder ◽  
James D. Slover
Keyword(s):  
New York ◽  
Total Hip Arthroplasty ◽  
Clinical Data ◽  
Hip Arthroplasty ◽  
New York State ◽  
York State ◽  
Total Hip

An Interview with Eddie Ellis

1998 ◽  
Vol 22 (1) ◽  
pp. 98-111 ◽  
Author(s):  
Don Goodman ◽  
Maggie Smith
Keyword(s):  
New York ◽  
Task Force ◽  
New York State ◽  
Think Tank ◽  
York State ◽  
Research Education ◽  
Community Justice ◽  
The Board Of Directors ◽  
Law And Justice ◽  
State Prisons

Edwin (Eddie) Ellis is President of the Community Justice Center, Inc., an anti-crime research, education, and advocacy organization located on 125th Street in Harlem, New York. A target of the FBI's Counter Intelligence Program (COINTELPRO) for his Black Panther Party activities, Ellis served 25 years in various New York State prisons. While he was in prison, he earned a Masters degree from New York Theological Seminary, a Bachelor's from Marist College and a paralegal degree from Sullivan County Community College. Widely recognized as a writer, lecturer, and community activist, Ellis is credited with the successful public dissemination of the research findings of the Think Tank, a group of prisoners from Greenhaven Correction Facility which established that 75% of the prisoners in New York State come from seven neighborhoods in New York City. Eddie Ellis is a fellow of the Bunche Dubois Institute for Public Policy at Medgar Evers College/CUNY, serves on the Board of Directors of Center for Law and Justice in Albany, NY, is a member of the Drug Policy Task Force, The Vera Institute IRB, and the National Criminal Justice Commission. This interview took place in the offices of the Community Justice Center on August 6, 1997.

Corruption and Racketeering in the New York City Construction Industry: The Final Report of the New York State Organized Crime Task Force.

ILR Review ◽  
1992 ◽  
Vol 45 (3) ◽  
pp. 606
Author(s):  
George W. Brooks ◽  
Ronald Goldstock ◽  
Martin Marcus ◽  
Thomas D. Thacher ◽  
James B. Jacobs
Keyword(s):  
New York ◽  
New York City ◽  
Construction Industry ◽  
Organized Crime ◽  
York City ◽  
Task Force ◽  
New York State ◽  
Final Report ◽  
York State ◽  
City Construction

scholarly journals Allocation of Ventilators in a Public Health Disaster

2008 ◽  
Vol 2 (1) ◽  
pp. 20-26 ◽  
Author(s):  
Tia Powell ◽  
Kelly C. Christ ◽  
Guthrie S. Birkhead
Keyword(s):  
Public Health ◽  
New York ◽  
Clinical Guidelines ◽  
Task Force ◽  
New York State ◽  
Assessment System ◽  
Ethical Framework ◽  
Standards Of Care ◽  
York State Department ◽  
York State

ABSTRACTBackground: In a public health emergency, many more patients could require mechanical ventilators than can be accommodated.Methods: To plan for such a crisis, the New York State Department of Health and the New York State Task Force on Life and the Law convened a workgroup to develop ethical and clinical guidelines for ventilator triage.Results: The workgroup crafted an ethical framework including the following components: duty to care, duty to steward resources, duty to plan, distributive justice, and transparency. Incorporating the ethical framework, the clinical guidelines propose both withholding and withdrawing ventilators from patients with the highest probability of mortality to benefit patients with the highest likelihood of survival. Triage scores derive from the sepsis-related organ failure assessment system, which assigns points based on function in 6 basic medical domains. Triage may not be implemented by a facility without clear permission from public health authorities.Conclusions: New York State released the draft guidelines for public comment, allowing for revision to reflect both community values and medical innovation. This ventilator triage system represents a radical shift from ordinary standards of care, and may serve as a model for allocating other scarce resources in disasters. (Disaster Med Public Health Preparedness. 2008;2:20–26)

scholarly journals Statewide CBT Training for Clinicians and Supervisors Treating Youth: The New York State Evidence Based Treatment Dissemination Center

2010 ◽  
Vol 19 (3) ◽  
pp. 182-192 ◽  
Author(s):  
Alissa A. Gleacher ◽  
Erum Nadeem ◽  
Amanda J. Moy ◽  
Andria L. Whited ◽  
Anne Marie Albano ◽  
...  
Keyword(s):  
New York ◽  
New York State ◽  
Evidence Based ◽  
York State ◽  
Evidence Based Treatment

scholarly journals Availability and Utilization of Automated External Defibrillators in New York State Schools

2021 ◽  
Vol 9 ◽  
Author(s):  
Milla Arabadjian ◽  
Stephanie Serrato ◽  
Mark V. Sherrid
Keyword(s):  
New York ◽  
Demographic Data ◽  
New York State ◽  
Policy Implications ◽  
Cross Sectional ◽  
Term Survival ◽  
Long Term Survival ◽  
Automated External Defibrillators ◽  
York State

Background: Use of automated external defibrillators (AEDs) in out-of-hospital cardiac arrests (OHCAs) improve survival. Professional health organizations recommend that AEDs be available in crowded places, including schools but currently only 18 US states require them. Sudden cardiac arrest (SCA) research in the school-age population has largely focused on school sub-groups, leaving out the majority of US students and adults working in schools. New York State (NYS) has one of the largest student populations in the US. Our objective was to gain epidemiologic data on SCA across a variety of school levels and examine the availability and utilization of AEDs in a state that requires them.Methods: This was an observational, cross-sectional study utilizing an electronic survey. We included NYS school nurses and collected electronic surveys in January-March, 2018. We analyzed demographic data of school characteristics, SCA occurrences and AED use and availability.Results: Of 876 respondents (36.1% response rate), 71 (8.2%) reported SCAs, with 41 occurring in adults. AEDs were deployed in 59 of 71 (84.3%) events, 40 individuals had long-term survival. Most SCAs occurred in middle-schools. School size or number of AEDs/school had no bearing on short-term or long-term survival. AEDs were widely available in private schools, though this was not required by state law.Conclusions: Our data suggest a need for more comprehensive examination of SCA in US schools. Research comparing the availability and utilization of school AEDs between states that do and do not require them is needed and may have important clinical and policy implications for SCA emergency preparedness in US schools.

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