Fit and healthy patients fall who ill with coronavirus should be given preference for critical care, new guidelines suggest.
Intensive care units at NHS hospitals have been overwhelmed by an influx of new patients with COVID-19, prompting fears over chronic bed shortages.
New guidance - issued by National Institute for Health and Care Excellence (NICE) - will see ICU doctors triage patients based on their overall activity level and health as well as their ability to recover.
Hospitals in Italy have been crudely forced to discriminate between patients based on their age as they struggle to deal with a spike in cases, resulting over 5,000 deaths of mainly elderly vcitims.
The NICE 'algorithm' does not categorise patients by age but instead asks medics to score patients on a nine-point “clinical frailty scale”, reports the Telegraph.
At one end of the scale, are patients with a “Very Fit” score of one and are described as “robust, active, energetic and motivated” and who “exercise regularly”.
At the other end, with a score of nine, are the “Terminally ill”.
The NICE algorithm divides patients at a score of five, the “Mildly Frail”.
Those with a score of less than five are likely to receive critical care, subject to a review of underlying conditions and the severity of their illness.
But patients who score a five or over will be put through a process where doctors must decide if critical care is "appropriate" before proceeding.
“For patients with confirmed Covid-19, decisions about admission to critical care should be made on the basis of medical benefit, taking into account the likelihood that the person will recover to an outcome that is acceptable to them and within a period of time consistent with the diagnosis,” says NICE.
Cancer patients with COVID-19 or those who need dialysis must also be carefully assessed ahead of receiving critical care.
“Where decisions need to be made about prioritising patients for treatment, these need to take into account the level of immunosuppression associated with individual treatments and cancer types,” it says.
NICE says it will update the guidance when more becomes available.
Last week, a major London hospital declared a “critical incident” due to a surge in patients with coronavirus.
A senior doctor at Northwick Park Hospital in Harrow said the situation was "petrifying."
In a message to staff, the hospital said it has no critical care capacity left and has contacted neighbouring hospitals about transferring patients who need critical care to other sites.
