The top five research priorities in physician-provided pre-hospital critical care: a consensus report from a European research collaboration

A European expert panel participated in a consensus process based upon a four-stage modified nominal group technique that included a consensus meeting.The 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.A 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.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]. To expand the area served and reduce transportation times, the first physician-manned helicopter emergency medical service (HEMS) became operational in Munich in 1968 [2]. Although 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) [3-6]. 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. Dispatch systems differ: some systems utilise immediate call-out criteria based on diagnoses or type of incident, whereas othe