The appropriate treatment of critically ill or injured patients can vary minute-to-minute. Thus, timely access to reliable data is one of the foundations of contemporary intensive care. It follows then that optimal responses during public health emergencies, for both clinicians and decision makers, would benefit from comprehensive, real-time event reporting. This should include physiological patient data that are needed to provide immediate insight into the impact of the event on critical health care resources and to identify groups with high risk for morbidity and mortality. The United States Critical Illness and Injury Trials Group Program for Emergency Preparedness (USCIITG-PREP) aims to significantly enhance the national capability to rapidly glean crucial information regarding the clinical course of acute illness and injury and guide clinical resource requirements during emergent events:
- Real-time collection of clinical data by a coordinating center during a regional or national public health emergency
- Rapid analysis of clinical data to address key analytic outcomes, answering both clinical and operational questions:
- What was the nature of the clinical insult and the resulting phenotype?
- As a clinical responder, what, if anything, did you have to do differently?
- Did clinical diagnostics, countermeasures, and therapies work as expected?
- What was the operational impact on the patient and care setting?
- Was there anything essential needed that you did not get?
- What is the best/worst case that could happen next time?
- Timely dissemination of event-related information to inform front-line treatment of disease and resource allocation, assuring patient confidentiality, data security, and strict version control
Working with the Office of the Assistant Secretary for Preparedness and Response (HHS/ASPR), leading professional organizations, and the Homeland Security Information Network (HSIN), USCIITG-PREP will develop mechanisms for rapid data collection, analysis, and dissemination of findings during public health emergencies. Pre-event work on protocols, data collection processes, rapid analysis techniques, and means to quickly disseminate findings to stakeholders are all crucial to making clinical science networks effective at enhancing the response. The USCIIT Group will leverage existing infrastructure to both strengthen pre-event operational science capabilities and provide timely data and situational awareness across the emergency care continuum during public health emergencies. Critical illness and injury professional organizations will use this rapid dissemination plan to inform their membership, in aggregate representing over 150,000 front-line clinicians, thereby saving lives and minimizing suffering based on the timely accurate guidance gleaned from operational science.