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Research in Emergency and Critical Care Settings: Debates, Obstacles and Solutions

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Abstract

Research is an integral part of evidence-based practice in the emergency department and critical care unit that improves patient management. It is important to understand the need and major obstacles for conducting research in emergency settings. Herein, we review the literature for the obligations, ethics and major implications of emergency research and the associated limiting factors influencing research activities in critical care and emergency settings. We reviewed research engines such as PubMed, MEDLINE, and EMBASE for the last two decades using the key words “emergency department”, “critical care”, “research”, “consent”, and “ethics” as the search terms. Research within emergency settings is slow or non-existent due to time and financial constraints as well as the lack of a research tradition. There are several barriers to conducting research studies in emergency situations such as who, what, when, and how to obtain patient consent. The emergency environment is highly pressurized, emotional, and overburdened. The time taken for research is a particular risk that could delay the desired immediate interventions. Ethical issues abound, particularly relating to informed consent. Research in emergency settings is still in its infancy. Thus, there is a strong need for extensive research in the emergency setting through community awareness, resource management, ethics, collaborations, capacity building, and the development of a research interest for the improvement of patient care and outcomes. We need to establish a well-structured plan to assess and track the decision-making capacity, consider a multistep enrolment and consent strategy, and develop an integrated approach for recruitment into studies.

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Acknowledgments

All authors read and approved the manuscript with no conflict of interest and no financial issue to disclose. All Authors have contributed in the design, data interpretation, manuscript drafting and approval. This Work received no specific grant from any funding agency in the public, commercial or not-for-profit sectors’.

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Authors and Affiliations

  1. Clinical Medicine, Weill Cornell Medical College, Doha, Qatar

    Ayman El-Menyar

  2. Clinical Research, Trauma Surgery Section, Hamad General Hospital, PO Box 3050, Doha, Qatar

    Ayman El-Menyar & Mohammad Asim

  3. Cardiology Unit, Internal Medicine, Ahmed Maher Teaching Hospital, Cairo, Egypt

    Ayman El-Menyar

  4. Department of Surgery, University of Arizona, Tucson, AZ, USA

    Rifat Latifi

  5. Trauma Surgery Section, Hamad Medical Corporation, Doha, Qatar

    Hassan Al-Thani

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  1. Ayman El-Menyar
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Correspondence to Ayman El-Menyar.

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El-Menyar, A., Asim, M., Latifi, R. et al. Research in Emergency and Critical Care Settings: Debates, Obstacles and Solutions. Sci Eng Ethics 22, 1605–1626 (2016). https://doi.org/10.1007/s11948-015-9730-5

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