40 simple steps to reduce deaths from critical illness

Carl Otto Schell. Photo credit: Stina Schell

Critical diseases result in millions of deaths worldwide each year, many of which could be avoided with basic life-saving care. Now, a new study led by researchers at the Karolinska Institutet is outlining a basic set of nursing interventions that experts around the world agree should be available to all critically ill patients. The study, published in the journal BMJ Global Health, offers hospitals a blueprint on how preventable deaths, including those from COVID-19, can be reduced.

Critical illness occurs when a patient’s vital organs become dysfunctional and there is a risk of imminent death. Critical illness can affect the patient’s airways, breathing, or circulatory system, and early detection of the problem and timely care can save lives. Unfortunately, this care is sometimes neglected in hospitals around the world, and improvements in healthcare can save many lives.

To this end, a group of clinicians and scientists led by researchers from the Karolinska Institutet, the Ifakara Health Institute in Tanzania and the London School of Hygiene & Tropical Medicine (LSHTM) developed the Essential Emergency and Critical Care (EECC) concept.

EECC

EECC describes a set of treatments and interventions that should be feasible in all hospital settings around the world. These are low-complexity, low-cost, life-saving practices that a group of more than 250 clinical experts from nearly 60 countries agreed would benefit critically ill patients.

The study asked the panel of experts – made up of a number of medical specialists from high, middle and low income countries – to evaluate a number of proposed treatments and interventions that were taken from the World Health Organization guidelines on basic emergency care. In three rounds, a consensus of over 90 percent of the experts was reached, resulting in a package of 40 clinical processes and 67 requirements for hospital readiness as well as another seven and nine for COVID-19.

Essential tool kit

“With the EECC package, we are providing healthcare professionals and political decision-makers with an indispensable toolkit of effective and inexpensive care that all hospitals should offer,” says the corresponding author Carl Otto Schell, Ph.D. Student at the Department of Global Public Health, Karolinska Institutet and consultant doctor at Nyköpings Hospital. “With these changes in practice, some of which are small, hospitals around the world could reduce the high mortality rate of critically ill patients.”

Examples of what EECC includes are:

• Detection of a critical illness through regular assessment of vital parameters such as pulse rate, oxygen saturation and blood pressure.
• Caring for patients with compromised airways, breathing difficulties, poor circulation or reduced consciousness through simple things like body positioning, oxygen therapy and intravenous hydration.
• General processes aimed at enabling a safe and functioning workflow, for example communication practices and separation from patients with infectious diseases.
• A list of items (equipment, supplies, medicines, training, infrastructure, and more) that a hospital needs to identify and care for critically ill patients.
• A dedicated section on caring for critically ill COVID-19 patients, including frequent monitoring of oxygen saturation and the use of heparin and corticosteroids.

Life saving care

“The COVID-19 pandemic has brought the importance of caring for critically ill patients into focus. If all hospitals in the world were able to provide EECC to all of their critically ill patients, many lives could be saved both during and after the pandemic. “Says Tim Baker, Associate Professor in the Department of Global Public Health, Karolinska Institutet, Ifakara Health Institute and LSHTM.

The researchers created the website of the EECC Network, a community of clinicians, researchers, policy makers and members of the public who want to improve the care of critically ill patients around the world.

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More information:
Carl Otto Schell et al., Essential Emergency and Critical Care: A Consensus Among Global Clinical Experts, BMJ Global Health (2021). DOI: 10.1136 / bmjgh-2021-006585 Provided by Karolinska Institutet

Quote: 40 Easy Steps to Reduce Serious Illness Deaths (2021, September 21), accessed September 21, 2021 from https://medicalxpress.com/news/2021-09-simple-deaths-kritische-illness.html

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