{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T12:58:57Z","timestamp":1740142737861,"version":"3.37.3"},"reference-count":30,"publisher":"FapUNIFESP (SciELO)","issue":"suppl 2","license":[{"start":{"date-parts":[[2021,1,1]],"date-time":"2021-01-01T00:00:00Z","timestamp":1609459200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,1,1]],"date-time":"2021-01-01T00:00:00Z","timestamp":1609459200000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,1,1]],"date-time":"2021-01-01T00:00:00Z","timestamp":1609459200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev. Bras. Saude Mater. Infant."],"abstract":"<jats:p>Abstract  Objectives: to develop a flow to ensure care for all people with severe acute respiratory syndrome Coronavirus 2, offering from intensive care to palliative care, in an equitable and fair manner.  Methods: the modified Delphi methodology was used to reach consensus on a flow and a prioritization index among specialists, the regional council of medicine, members of the healthcare system and the local judicial sector.  Results: the score was incorporated into the flow as the final phase for building the list of patients who will be referred to intensive care, whenever a ventilator is available. Patients with lower scores should have priority access to the ICU. Patients with higher scores should receive palliative care associated with available curative measures. However, curative measures must be proportionate to the severity of the overall clinical situation and the prognosis.  Conclusions: this tool could and will prevent patients from being excluded from access to the necessary health care so that their demands are assessed, their suffering is reduced, and their illnesses are cured, when possible.<\/jats:p>","DOI":"10.1590\/1806-9304202100s200011","type":"journal-article","created":{"date-parts":[[2021,7,3]],"date-time":"2021-07-03T01:45:13Z","timestamp":1625276713000},"page":"519-527","source":"Crossref","is-referenced-by-count":3,"title":["Prioritization to ensure care in COVID-19 pandemic"],"prefix":"10.1590","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1130-1098","authenticated-orcid":false,"given":"Mirella Rebello","family":"Bezerra","sequence":"first","affiliation":[{"name":"Instituto de Medicina Integral Prof. Fernando Figueira,  Brasil"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4645-8343","authenticated-orcid":false,"given":"Maria J\u00falia Gon\u00e7alves de","family":"Mello","sequence":"additional","affiliation":[{"name":"Instituto de Medicina Integral Prof. Fernando Figueira,  Brasil"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2671-3570","authenticated-orcid":false,"given":"Jurema Telles de Oliveira","family":"Lima","sequence":"additional","affiliation":[{"name":"Instituto de Medicina Integral Prof. Fernando Figueira,  Brasil"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6106-7191","authenticated-orcid":false,"given":"Zilda do R\u00eago","family":"Cavalcanti","sequence":"additional","affiliation":[{"name":"Instituto de Medicina Integral Prof. Fernando Figueira,  Brasil"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1400-8666","authenticated-orcid":false,"given":"Guacyra Magalh\u00e3es Pires","family":"Bezerra","sequence":"additional","affiliation":[{"name":"N\u00facleo de Oncologia do Agreste,  Brasil"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6714-1970","authenticated-orcid":false,"given":"Laiane Moraes","family":"Dias","sequence":"additional","affiliation":[{"name":"Hospital Universit\u00e1rio Jo\u00e3o de Barros Barreto,  Brasil"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6066-9484","authenticated-orcid":false,"given":"Priscilla Karen de Oliveira","family":"S\u00e1","sequence":"additional","affiliation":[{"name":"Hospital de Emerg\u00eancia e Trauma de Campina Grande,  Brasil"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1377-9899","authenticated-orcid":false,"given":"Rui","family":"Nunes","sequence":"additional","affiliation":[{"name":"Universidade do Porto,  Portugal"}]}],"member":"530","published-online":{"date-parts":[[2021]]},"reference":[{"issue":"18","key":"ref1","doi-asserted-by":"crossref","first-page":"1773","DOI":"10.1001\/jama.2020.5046","article-title":"A Framework for Rationing Ventilators and Critical Care Beds during the COVID-19 Pandemic","volume":"323","author":"White DB","year":"2020","journal-title":"JAMA"},{"key":"ref2","first-page":"10","article-title":"Marco \u00c9tico Pandemia Covid 19","author":"Espinosa E","year":"2020","journal-title":"Soc Espa\u00f1ola Anestesiol Reanim y Ter del dolor"},{"key":"ref3","doi-asserted-by":"crossref","DOI":"10.1002\/hast.1090","article-title":"Responding to COVID-19: How to Navigate a Public Health Emergency Legally and Ethically","author":"Gostin LO","year":"2020","journal-title":"Hastings Cent Rep [Internet]"},{"issue":"2","key":"ref4","doi-asserted-by":"crossref","first-page":"13","DOI":"10.7326\/0003-4819-150-2-200901200-00011","article-title":"Who should receive life support during a public health emergency? Using ethical principles to improve allocation decisions","volume":"150","author":"White DB","year":"2009","journal-title":"Ann Intern Med"},{"issue":"21","key":"ref5","doi-asserted-by":"crossref","first-page":"2049","DOI":"10.1056\/NEJMsb2005114","article-title":"Fair Allocation of Scarce Medical Resources in the Time of Covid-19","volume":"382","author":"Emanuel EJ","year":"2020","journal-title":"N Engl J Med"},{"issue":"4","key":"ref6","doi-asserted-by":"crossref","first-page":"414","DOI":"10.1017\/cem.2020.352","article-title":"End-of-life care in the emergency department for the patient imminently dying of a highly transmissible acute respiratory infection (such as COVID-19)","volume":"22","author":"Hendin A","year":"2020","journal-title":"CJEM"},{"series-title":"Resolu\u00e7\u00e3o n\u00b0 2.217, de 27 de setembro de 2018 - Imprensa Nacional [Internet]","key":"ref7"},{"issue":"2","key":"ref8","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1089\/hs.2020.0028","article-title":"Strategies to Inform Allocation of Stockpiled Ventilators to Healthcare Facilities During a Pandemic","volume":"18","author":"Koonin LM","year":"2020","journal-title":"Heal Secur"},{"issue":"11","key":"ref9","doi-asserted-by":"crossref","first-page":"1377","DOI":"10.1503\/cmaj.060911","article-title":"Development of a triage protocol for critical care during an influenza pandemic","volume":"175","author":"Christian MD","year":"2006","journal-title":"CMAJ"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1016\/j.ienj.2018.10.004","article-title":"Ethical prioritization of patients during disaster triage: a systematic review of current evidence","volume":"43","author":"Ghanbari V","year":"2019","journal-title":"Int Emerg Nurs"},{"issue":"2","key":"ref11","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1016\/S0733-8627(01)00008-6","article-title":"Mass casualty management of a large-scale bioterrorist event: An epidemiological approach that shapes triage decisions","volume":"20","author":"Burkle FM","year":"2002","journal-title":"Emerg Med Clin North Am"},{"issue":"3","key":"ref12","first-page":"655","article-title":"How to use the nominal group and Delphi techniques","volume":"38","author":"McMillan SS","year":"2016","journal-title":"Int J Clin Pharm"},{"year":"2020","series-title":"Princ\u00edpios de triagem em situa\u00e7\u00f5es de cat\u00e1strofes e as particularidades da pandemia COVID-19","key":"ref13"},{"journal-title":"Cons Fed Med [Internet]","article-title":"Resolu\u00e7\u00e3o CFM no 2.156\/2016","year":"2016","key":"ref14"},{"year":"2020","series-title":"COVID-19 rapid guideline: critical care in adults NICE guideline [NG159] [Internet]","key":"ref15"},{"year":"2020","series-title":"Manejo do idoso com infec\u00e7\u00e3o grave pelo COVID-19 em ambiente hospitalar: IVCF-20 on-line","author":"Com I","key":"ref16"},{"year":"2016","series-title":"The Gold Standards Framework Proactive Identification Guidance ( PIG )","author":"Guidance PI","key":"ref17"},{"year":"2020","series-title":"Fluxo de manejo cl\u00ednico do adulto e idoso na Aten\u00e7\u00e3o Especializada [Internet]","key":"ref18"},{"first-page":"12","year":"2020","series-title":"Posicionamento da Academia Nacional de Cuidados Paliativos sobre COVID-19 - Academia Nacional de Cuidados Paliativos [Internet]","key":"ref19"},{"first-page":"169","year":"2006","series-title":"Resolu\u00e7\u00e3o CFM no 1.805 [Internet]","key":"ref20"},{"issue":"3","key":"ref21","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1136\/bmjspcare-2013-000488","article-title":"Development and evaluation of the supportive and palliative care indicators tool (SPICT): A mixed-methods study","volume":"4","author":"Highet G","year":"2014","journal-title":"BMJ Support Palliat Care"},{"issue":"6","key":"ref22","doi-asserted-by":"crossref","first-page":"R161","DOI":"10.1186\/cc7160","article-title":"Evaluation of SOFA-based models for predicting mortality in the ICU: A systematic review","volume":"12","author":"Minne L","year":"2008","journal-title":"Crit Care"},{"issue":"3","key":"ref23","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1590\/S0102-311X2008000300018","article-title":"Avalia\u00e7\u00e3o do \u00edndice de comorbidade de Charlson em interna\u00e7\u00e3es da regi\u00e3o de Ribeir\u00e3o Preto, S\u00e3o Paulo, Brasil","volume":"24","author":"Martins M","year":"2008","journal-title":"Cad Sa\u00fade P\u00fablica"},{"issue":"2","key":"ref24","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1097\/MLR.0000000000000471","article-title":"The best use of the charlson comorbidity index with electronic health care database to predict mortality","volume":"54","author":"Bannay A","year":"2016","journal-title":"Med Care"},{"key":"ref25","article-title":"The comprehensive geriatric assessment in malignancies and prognostic factors: Description of a prospective cohort of 889 Brazilian elderly cancer patients","volume":"37","author":"Lima J","year":"2019","journal-title":"J Clin Oncol"},{"issue":"2","key":"ref26","doi-asserted-by":"crossref","first-page":"121","DOI":"10.5327\/Z2447-211520181800023","article-title":"Consenso brasileiro de fragilidade em idosos: conceitos, epidemiologia e instrumentos de avalia\u00e7\u00e3o","volume":"12","author":"Louren\u00e7o RA","year":"2018","journal-title":"Geriatr Gerontol Aging"},{"issue":"1","key":"ref27","first-page":"38","article-title":"Clinical Frailty Scale: Translation and Cultural Adaptation Into the Brazilian Portuguese Language","volume":"10","author":"Rodrigues MK","year":"2021","journal-title":"J Frailty Aging"},{"issue":"170","key":"ref28","first-page":"269","article-title":"Resolu\u00e7\u00e3o CFM n\u00b0 1.995\/2012. Disp\u00f5e sobre as diretivas antecipadas de vontade dos pacientes","journal-title":"Di\u00e1rio Oficial da Uni\u00e3o de 31 de agosto de 2012"},{"key":"ref29","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1186\/1472-6947-13-72","article-title":"Appraisal of the Karnofsky Performance Status and proposal of a simple algorithmic system for its evaluation","volume":"13","author":"P\u00e9us D","year":"2013","journal-title":"BMC Med Inform Decis Mak"},{"first-page":"1","year":"2020","series-title":"Ethics and COVID-19: resource allocation and priority-setting. World Health Organ [Internet]","key":"ref30"}],"container-title":["Revista Brasileira de Sa\u00fade Materno Infantil"],"original-title":[],"link":[{"URL":"http:\/\/www.scielo.br\/pdf\/rbsmi\/v21s2\/1519-3829-rbsmi-21-s2-0519.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,7,3]],"date-time":"2021-07-03T01:45:36Z","timestamp":1625276736000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_arttext&pid=S1519-38292021000300519&tlng=en"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021]]},"references-count":30,"journal-issue":{"issue":"suppl 2","published-online":{"date-parts":[[2021]]}},"alternative-id":["S1519-38292021000300519"],"URL":"https:\/\/doi.org\/10.1590\/1806-9304202100s200011","relation":{},"ISSN":["1806-9304","1519-3829"],"issn-type":[{"type":"electronic","value":"1806-9304"},{"type":"print","value":"1519-3829"}],"subject":[],"published":{"date-parts":[[2021]]}}}