RT Journal Article
SR Electronic
T1 Essential Emergency and Critical Care: a consensus among global clinical experts
JF BMJ Global Health
JO BMJ Global Health
FD BMJ Publishing Group Ltd
SP e006585
DO 10.1136/bmjgh-2021-006585
VO 6
IS 9
A1 Carl Otto Schell
A1 Karima Khalid
A1 Alexandra Wharton-Smith
A1 Jacquie Oliwa
A1 Hendry R Sawe
A1 Nobhojit Roy
A1 Alex Sanga
A1 John C Marshall
A1 Jamie Rylance
A1 Claudia Hanson
A1 Raphael K. Kayambankadzanja
A1 Lee A Wallis
A1 Maria Jirwe
A1 Tim Baker
A1 ,
YR 2021
UL http://gh.bmj.com/content/6/9/e006585.abstract
AB 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.All data relevant to the study are included in the article or uploaded as supplementary information. Access to anonymised data may be provided to researchers after provision of a study protocol and justification to the corresponding author.