North Texas Mass Critical Care Guidelines

In a mass disaster when medical resources may be overwhelmed, these guidelines were created and adopted by all of the North Texas hospital, health system, and physician communities to best ensure survival for the most patients. The guidelines were adopted based on successful models in numerous states across the country. They contain a framework in which healthcare providers, hospitals and other clinical settings can create decision-making tools during a mass disaster. 

The three major goals of this process are to: 1) save as many lives as possible; 2) help patients and families in North Texas become more aware of the difficult decisions the health care system must make during times in which the demand for medical services outstrips the supply of such services; and 3) seek consistency in decision making among the many health systems.

These guidelines were built on a triage framework using ethical principles to assist hospitals, other healthcare institutions, as well as physicians in making treatment and triage decisions which may differ from the traditional standards of care. 

The guidelines seek to reduce disparities between currently existing disaster triage frameworks in order for citizens of the region to be confident that the care they receive in such an emergency is consistent from institution to institution.

On July 22, 2020, the Guidelines were amended by the North Texas Mass Critical Care Guidelines Taskforce to include explicit statements of non-discrimination; the removal of explicit categorical Exclusion Criteria, replacing those with language indicating individual evaluation of each patient based upon clinician judgement of the risk of imminent or near imminent mortality; and the insertion of SOFA score alongside MSOFA, allowing each organization and/or individual physicians to choose the tool they feel is most appropriate for the clinical circumstance of the moment.
Links to the amended Guidelines are below:

North Texas Mass Critical Care History