학술논문
Essential Emergency and Critical Care: a consensus among global clinical experts
Document Type
article
Author
Samuel Akech; Mike English; Thomas G Weiser; Adam D Laytin; Niranjan Kissoon; Jaran Eriksen; Lovenish Bains; Fred Bulamba; Claudia Hanson; Maria Jirwe; Jolene Moore; Mpoki Ulisubisya; Vincent Ioos; Kent Doi; Lee A Wallis; Tom Bashford; Kapil Dev Soni; Nobhojit Roy; Franco Diaz; Mulinda Nyirenda; Nicholas Risko; Hendry R Sawe; Jacob McKnight; Alexandra Wharton-Smith; Jamie Rylance; Monty Khajanchi; Gavin Wooldridge; Emmanuel Fru Nsutebu; Lisa Kurland; Peter Baker; John C Marshall; Kathryn Rowan; Usha Lalla; Balasubramanian Venkatesh; Cornelius Sendagire; Neill KJ Adhikari; Tim Baker; Brian Rice; Josephine Langton; Elisabeth Riviello; Fiona Muttalib; Francis Mupeta; Jacquie Oliwa; Stefan Swartling Peterson; Andrew G Smith; Lorna Guinness; Megan Cox; Wim Van Damme; John Kellett; Elizabeth M Molyneux; Richard Venn; Andrea B Pembe; Mervyn Mer; Ignacio Martin-Loeches; Raymond Towey; Lina Zhang; Blaise Pascal; Hiral A Shah; Carl Otto Schell; Karima Khalid; Paul D Sonenthal; Alex Sanga; Raphael K. Kayambankadzanja; Adam Asghar; Adrian J Holloway; Ahmed Rhassane El Adib; Alexia Michaelides; Alvaro Coronado Munoz; Amos Muzuka; Analía Fernández; Andreas Wellhagen; Anita Gadgil; Anna Hvarfner; Anuja Abayadeera; Asya Agulnik; Aurélie Godard; Bargo Mahamat Yousif; Bhakti Sarang Ben Morton; Bharath Kumar; Tirupakuzhi Vijayaraghavan; Bobby King; C Louise Thwaites; Chian Wern Tai; Christian Owoo; Dan Brun Petersen; Daniel Tatay; David Lee Skinner; Denis Kinyua; Dhruva Ghosh; Diptesh Aryal; Donald Mlombwa; Duyen Thi; Hanh Bui; Edwin R Lugazia; Ellena Heyns; Erika Montalvo; Ernesto Gerardo Moreno; Esther Banda Kanyangira; Furaha Nzanzu; Gibonce Mwakisambwe; Guy A Richards; Hala Ammar; Halinder S Mangat; Hasanein H Ghali; Hoi Ping Shum; Ibrahim Salim Abdullahi; Ingrid T von der Osten; James S Lee; Jane Kasozi Namagga; Jasmine Armour-Marshall; John Z Metcalfe; Jonas Blixt; Juan Gutierrez Mejia; Juan Ignacio Silesky-Jiménez; Karl Martin Kohne; Kazuhiro Yokobatake; Kristina E. Rudd; Kwame Asante Akuamoah-Boateng; Lars Irestedt; Lia I Losonczy; Margaret Nyaika; Markus Castegren; Matthew Loftus; Matti Reinikainen; Michael Jaung; Michael S Lipnick; Miklos Lipcey; Märit Amanda Halmin; Naman Shah; Natalie L Cobb; Nathan D Nielsen; Neville Vlok; Ntogwiachu Daniel Kobuh; Oscar Fernández Rostello; Patricia Duque; Paul Patrick Mwasapi; Petronella Bjurling-Sjöberg; Piedad Sarmiento; Pryanka Relan; Rebecca Silvers; Rehema Mlay; Rich Branson; Richard J Wang; Richard Kojan; Richard Peter Von Rahden; Rob Mac Sweeney; Rodrigo Genaro Arduini; Rodwell Gundo; Ruyumbu Sixtus; Samson Kwazizira Mndolo; Shada A. Rouhani; Siriel Nanzia Massawe; Steven A Webb; Sunkaru Touray; Susana Guido; Teresa Kortz; Theodoros Aslanidis; Traci A Wolbrink; V Theodore Barnett; Vijay Christopher Kannan; Waleed S Eldebsy; Wangari Waweru-Siika; Wezzie Kumwenda Mwafulirwa; William Obeng; Yasein Omer; Zione Banda
Source
BMJ Global Health, Vol 6, Iss 9 (2021)
Subject
Language
English
ISSN
2059-7908
Abstract
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.