In order to standardize the process, triage teams should use an established institutional, system, or statewide process and algorithm. These algorithms should avoid discrimination based on factors not medically relevant. In the absence of disease-specific risk stratification or mortality prediction models, mortality prediction scores, such as sequential organ failure assessment (SOFA) and pediatric logistic organ dysfunction (PELOD), have been widely adopted in triage algorithms.

Physicians, staff, and administrators should maintain transparency with patients and the community. Providers and triage teams should assist patients and families by communicating the reasons for allocation determinations, and should offer supportive services, including ethics consultants, palliative care, social work, and chaplaincy

References

1. Richardson S^,Jamie S. Hirsch JS, et al. Presenting characteristics, comorbidities, and outcomes among 5700 patients hospitalized with COVID-19 in the New York City area. JAMA. 2020;323(20):2052-2059.
2. Edelson DP, Sasson C, Chan PS, et al. Interim guidance for basic and advanced life support in adults, children, and neonates with suspected or confirmed COVID-19. Circulation. 2020;141:e933–e943
3. Nonbeneficial (“futile”) emergency medical interventions. Available at: https://www.acep.org/patient-care/policy-statements/nonbeneficial-futile-emergency-medical-interventions/. Accessed May 14, 2020.
4. Truog RD, Mitchell C, Daley GQ. The toughest triage—allocating ventilators in a pandemic. N Engl J Med. 2020;382(21):1973-1975.

Dr. Baker is professor of medical ethics at the University of Toledo College of Medicine and Life Sciences, Toledo, Ohio.

Dr. Moskop is professor of general internal medicine at the Wake Forest School of Medicine.

Dr. Vearrier is is an emergency medicine physician at the University of Mississippi Medical Center in Jackson.

Dr. Derse is the Julia and David Uihlein Chair in Medical Humanities at the Medical College of Wisconsin.

Dr. Marco is professor of emergency medicine & surgery at Wright State University.

Dr. Simon is associate professor of emergency medicine at Columbia University.