Emergency critical care: a blind spot in the upstream phase of critical illness
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By
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Philipp Kümpers
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Alexandros Rovas
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Richard Köhnke
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Linus Pinkernell
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Michael Reindl
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Mark Michael
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Michael Bernhard
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April 19, 2026
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Clinical Scorecard: Critical Care in Emergencies: Overlooked Aspects in the Early Stages of Severe Illness
At a Glance
| Category | Detail |
|---|
| Condition | Emergency Critical Care (ECC) |
| Key Mechanisms | Management of physiological instability requiring sustained monitoring and intervention. |
| Target Population | Critically ill patients in emergency departments awaiting ICU transfer. |
| Care Setting | Emergency Departments (EDs) |
Key Highlights
- ECC is often poorly defined and conceptualized within critical care.
- Emergency physicians deliver high-acuity care in EDs, often indistinguishable from ICU management.
- ECC can shorten time to advanced care and reduce short-stay ICU admissions.
Guideline-Based Recommendations
Diagnosis
- Recognize the need for intensive care during the early phase in the ED.
Management
- Implement sustained monitoring, intervention, and trajectory-guided clinical decision-making.
Monitoring & Follow-up
- Utilize a framework to assess disease severity, clinical care intensity, and therapeutic organ support.
Risks
- Fragmented accountability may lead to variability in practice and potential safety risks.
Patient & Prescribing Data
Critically ill patients requiring prolonged high-acuity treatment in EDs.
ECC serves as an upstream filter, preserving ICU capacity for patients with sustained organ failure.
Clinical Best Practices
- Define ECC as a legitimate component of critical illness management.
- Develop shared governance structures for critically ill patients during the transitional phase.
References
