The article is a thoughtful assessment of important issues surrounding ventilator allocation during a large-scale disaster. Although the article emphasizes the importance of developing a decision-making process that will be followed during a disaster, it recognizes that some processes and tools will be event-driven. Thus, implementation of certain procedures will depend on the nature of the disaster and occur during the event. Useful tools include an example of a decision-making process, a decision matrix for ventilator triage, ethical and operational goals, and decision-making support tools. One reviewer noted that this article is an excellent resource for critical care physicians and inpatient healthcare facilities that are attempting to develop a rational ventilator allocation scheme in preparation for a disaster.