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Essential Emergency and Critical Care: a consensus among global clinical experts.
Karolinska Institutet, Sweden; Uppsala University, Sweden; Nyköping Hospital, Sweden .ORCID iD: 0000-0002-7904-1336
Muhimbili University of Health and Allied Sciences, United Republic of Tanzania; Ifakara Health Institute, United Republic of Tanzania.
London School of Hygiene & Tropical Medicine, UK.ORCID iD: 0000-0001-5335-2059
KEMRI-Wellcome Trust Research Programme Nairobi, Kenya; University of Nairobi, Kenya.
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2021 (English)In: BMJ Global Health, E-ISSN 2059-7908, Vol. 6, no 9, article id e006585Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Globally, critical illness results in millions of deaths every year. Although many of these deaths are potentially preventable, the basic, life-saving care of critically ill patients are often overlooked in health systems. Essential Emergency and Critical Care (EECC) has been devised as the care that should be provided to all critically ill patients in all hospitals in the world. EECC includes the effective care of low cost and low complexity for the identification and treatment of critically ill patients across all medical specialties. This study aimed to specify the content of EECC and additionally, given the surge of critical illness in the ongoing pandemic, the essential diagnosis-specific care for critically ill patients with COVID-19.

METHODS: In a Delphi process, consensus (>90% agreement) was sought from a diverse panel of global clinical experts. The panel iteratively rated proposed treatments and actions based on previous guidelines and the WHO/ICRC's Basic Emergency Care. The output from the Delphi was adapted iteratively with specialist reviewers into a coherent and feasible package of clinical processes plus a list of hospital readiness requirements.

RESULTS: The 269 experts in the Delphi panel had clinical experience in different acute medical specialties from 59 countries and from all resource settings. The agreed EECC package contains 40 clinical processes and 67 requirements, plus additions specific for COVID-19.

CONCLUSION: The study has specified the content of care that should be provided to all critically ill patients. Implementing EECC could be an effective strategy for policy makers to reduce preventable deaths worldwide.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2021. Vol. 6, no 9, article id e006585
Keywords [en]
COVID-19, health policy, health services research, health systems, surgery
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Nursing
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URN: urn:nbn:se:rkh:diva-4100DOI: 10.1136/bmjgh-2021-006585PubMedID: 34548380OAI: oai:DiVA.org:rkh-4100DiVA, id: diva2:1597918
Available from: 2021-09-28 Created: 2021-09-28 Last updated: 2021-09-28Bibliographically approved

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Jirwe, Maria

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