MSA CoA MSIC Joint Statement on Critical Care Triage during the COVID 19 Pandemic

27th July 2021, Kuala Lumpur

The current COVID-19 wave in Malaysia has led to an overwhelming number of the critically ill Category 4 and 5 cases. The current available critical care resources are not adequate to cater for this surge. This document is meant as a guide for critical care providers to perform ethical triage in this pandemic or any other disaster situations.

Critical care triage is the process of allocating the scarce critical care resources in disaster situations to ensure the best possible outcome for most patients.

Recommendations for Critical Care Triage
Triage is to bring the greatest benefit for the most number of patients, while maintaining the function of the critical care services.

All patients who require critical care are considered by the same triage criteria without any preference.

When feasible, the goals of critical care are to be discussed with the patients and their family member(s). The acceptability of critical care interventions by the patient should be ascertained whenever possible. Advanced care plans or directives should be made known to the triaging physicians.

Triage is performed by critical care providers in discussion with the Infectious Disease (ID) specialist. Senior critical care provider(s) may be consulted, and hospital management may need to be involved.

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The College of Anaesthesiologists, Academy of Medicine of Malaysia; the Malaysian Society of Anaesthesiologists and the Malaysian Society of Intensive Care would like to respond on the press statement by the Health Minister, Datuk Seri Dr Adham Baba, as reported by the Bernama News Agency on 20 th June 2021 with regards to the purchase of 500 negative pressure ambulances to transport Covid-19 patients.

We would like to affirm the Societies’ understanding of the necessity of ambulance services in transferring patients from their homes and/or Covid quarantine centres to hospitals for more urgent medical care. However, the use of negative pressure ambulances specifically has not been shown to confer any significant benefit.

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PRESS STATEMENT: COVID-19 Vaccinated Individuals Requiring Anaesthesia (13th June 2021)

The Malaysian Society of Anaesthesiologists and the College of Anaesthesiologists, Academy of Medicine of Malaysia strongly refute the misleading message circulating on the social platform on the causation and / or adverse reactions of anaesthesia against COVID-19 vaccinated individuals. To date, there is no scientific evidence to validate the unfounded misinformation. Allowing such misstatements to propagate may impact many vulnerable individuals awaiting anaesthesia for surgical procedures and their inclination for vaccination. Hence the need for us to address this with urgency.

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PRESS STATEMENT: COVID-19 Crisis: To Win, Healthcare Providers Must Unite (17th January 2021)

We refer to the recent call made by the Ministry of Health Malaysia to private hospitals and their doctors to help with the management of COVID-19 patients.

The Malaysian Society of Anaesthesiologists representing 1200 members, the College of Anaesthesiologists, Academy of Medicine of Malaysia representing 900 academicians in Anaesthesiology and Critical Care, and the Malaysian Society of Intensive Care representing 200 members are humbled by the call from the Ministry of Health for us to stand united as a team in the quest to care for the COVID-19 patients. As we write this, we understand that ongoing meetings are being held between stakeholders from the Ministry of Health and the Association of Private Hospitals Malaysia (APHM) to further outline strategies for the involvement of the private sector in handling COVID-19 patients in various stages of their illness.

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