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Defining Critical Emergency Medicine (CrEM): A Delphi Study From Scandinavia.

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Critical emergency medicine (CrEM) is now defined as a distinct physician-led subspecialty. This consensus-based framework outlines CrEM

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Area of Science:

  • Anesthesiology and Intensive Care Medicine
  • Emergency Medicine
  • Medical Subspecialties

Background:

  • Critical emergency medicine (CrEM) is a recognized subspecialty within anesthesiology and intensive care medicine.
  • A comprehensive definition and framework for CrEM were previously lacking.
  • This study aimed to establish a consensus-based definition and delineate CrEM's core components.

Purpose of the Study:

  • To establish a consensus-based definition of Critical Emergency Medicine (CrEM).
  • To delineate the core components, competencies, and operational domains of CrEM.
  • To provide a framework supporting CrEM curriculum development and clinical governance.

Main Methods:

  • A modified Delphi study involving experts from the SSAI-CrEM education program.
  • Two iterative rounds of evaluation followed by external validation with program alumni.
  • Consensus defined as ≥90% agreement on statements refined by a steering committee.

Main Results:

  • 37 out of 44 statements reached consensus, organized into six thematic domains.
  • CrEM defined as a physician-led, context-adapted subspecialty for rapid stabilization and high-acuity care.
  • Emphasis on structured training, ethical competence, leadership, and scientific development.

Conclusions:

  • CrEM is a distinct and essential subspecialty bridging advanced emergency care across settings.
  • The defined framework supports curriculum development, clinical governance, and research in CrEM.
  • Further validation and evolution of CrEM in clinical and academic contexts are recommended.