Essential Emergency and Critical Care: a consensus among global clinical experts

Carl Otto Schell, Karima Khalid, Alexandra Wharton-Smith, Jacquie Oliwia, Hendry Safe, Nobhojit Roy, Alex Sanga, John C Marshall, Jamie Rylance, Claudia Hanson, Raphael K. Kayambankadzanja, Lee A Wallis, Maria Jirwe, Tim Baker, The EECC Collaborators

Research output: Contribution to journalArticlepeer-review

40 Citations (Scopus)
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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.
Original languageEnglish
Article numbere006585
Number of pages12
JournalBMJ Global Health
Issue number9
Early online date21 Sept 2021
Publication statusPublished - 21 Sept 2021

Bibliographical note

We thank the World Federation of Intensive and Critical Care (WFICC) for supporting the study. We also thank all experts who participated in the Delphi panel, those who took part in piloting the questions, and Anders Wennerstrand for communications advice.

Data Availability Statement

All data relevant to the study are included in the article or uploaded as supplementary information.


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