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A disaster medicine team augmented staff during a COVID-19 surge on the Texas-Mexico border, highlighting the medicolegal and ethical issues of expanding scope of practice for critical care. A framework for future disaster staffing is presented.

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Area of Science:

  • Disaster Medicine
  • Critical Care
  • Public Health Emergencies

Background:

  • The COVID-19 pandemic created unprecedented challenges for healthcare systems.
  • Surges in cases strained resources, particularly in intensive care units (ICUs).
  • Staffing shortages necessitated innovative solutions for patient care delivery.

Purpose of the Study:

  • To describe a disaster medicine team's response to a COVID-19 surge at the Texas-Mexico border.
  • To examine the medicolegal and ethical considerations of healthcare providers working outside their usual scope of practice.
  • To propose a framework for future disaster-related staff augmentation.

Main Methods:

  • Deployment of an emergency medicine attending physician team, including a nurse practitioner and physician assistant.
  • Assignment of augmented staff to ICU settings under intensivist supervision.
  • Analysis of the medicolegal and ethical implications of cross-disciplinary practice.

Main Results:

  • The team provided critical care support during a significant COVID-19 surge.
  • Working outside established scopes of practice presented unique medicolegal and ethical challenges.
  • The experience informed the development of a disaster staffing framework.

Conclusions:

  • Cross-disciplinary staff augmentation can be a viable strategy during healthcare disasters.
  • Clear guidelines and ethical frameworks are crucial when providers work outside their traditional scope.
  • The proposed framework can guide future disaster response efforts for optimal resource allocation.