ABSTRACT
Influenza pandemic remains the top risk in the UK cabinet office national risk register of civil emergencies. Pandemic planning aims to minimise avoidable mortality and morbidity. The worst pandemic of the twentieth century was "Spanish 'flu", which began in 1918, killing about 50 million people, 3% of the world's population. A full pandemic is likely to overwhelm healthcare resources, necessitating rationing, triage and uncomfortable ethical choices. Further influenza pandemics occurred in 1957 and 1968, each killing about one million people. Most infections cause mild respiratory disease, although each year people do die from influenza, usually among the more vulnerable groups, such as older people. Respiratory failure usually necessitates intubation and invasive ventilation. While such airway management is familiar to intensive care unit nurses, many victims are likely to be young children. Virulence of epidemic influenza will necessitate precautions to minimise risks to staff and family.
