Abstract
BackgroundPhysician-manned emergency medical teams supplement other emergency medical services in some countries. These teams are often selectively deployed to patients who are considered likely to require critical care treatment in the pre-hospital phase. The evidence base for guidelines for pre-hospital triage and immediate medical care is often poor. We used a recognised consensus methodology to define key priority areas for research within the subfield of physician-provided pre-hospital critical care.MethodsA European expert panel participated in a consensus process based upon a four-stage modified nominal group technique that included a consensus meeting.ResultsThe expert panel concluded that the five most important areas for further research in the field of physician-based pre-hospital critical care were the following: Appropriate staffing and training in pre-hospital critical care and the effect on outcomes, advanced airway management in pre-hospital care, definition of time windows for key critical interventions which are indicated in the pre-hospital phase of care, the role of pre-hospital ultrasound and dispatch criteria for pre-hospital critical care services.ConclusionA modified nominal group technique was successfully used by a European expert group to reach consensus on the most important research priorities in physician-provided pre-hospital critical care.
Highlights
Physician-manned emergency medical teams supplement other emergency medical services in some countries
The concept of a physician-manned pre-hospital emergency medical team was born in the early 1950s, and the first physician-manned mobile intensive care unit (MICU) was put into service in Heidelberg, Germany, in 1957 [1]
Physician-staffed emergency medical services (EMS) are a limited resource due to the capacity and costs associated with the equipment, staffing and training and are often selectively deployed by helicopter or land-based emergency response vehicles to patients considered likely to require critical care treatment in the pre-hospital phase
Summary
Physician-manned emergency medical teams supplement other emergency medical services in some countries These teams are often selectively deployed to patients who are considered likely to require critical care treatment in the pre-hospital phase. Ambulance personnel or nurses are usually the first pre-hospital medical personnel to assess the critically ill or injured patient, many countries in Europe and, to some extent, Australasia, commonly deploy physicians, often anaesthesiologists, in pre-hospital emergency medical services (EMS) [3,4,5,6]. Physician-staffed EMS are a limited resource due to the capacity and costs associated with the equipment, staffing and training and are often selectively deployed by helicopter or land-based emergency response vehicles to patients considered likely to require critical care treatment in the pre-hospital phase. Separation of the pre-hospital component of care from the entire trauma patient pathway limits the utility of these studies and makes reliable conclusions about pre-hospital care difficult [21,22,23,24]
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