Members of an American College of Emergency Physicians/Society of Academic Emergency Medicine Task Force brought together to collaborate with the National Institutes of Health (NIH) to advance emergency medicine research were recently rewarded with a momentous event to mark their efforts: the announcement of a national K12 career development grant program specifically for emergency medicine researchers.

The National Heart, Lung, and Blood Institute (NHLBI) Research Career Development Programs in Emergency Medicine Research grant will allow emergency medicine researchers to secure advanced training in research techniques that they can then apply directly to questions affecting patient care. According to its Web site, the NHLBI intends to commit approximately $1.08 million in 2011 and $20.79 million in total costs over a 5-year period in support of the program.

“Emergency medicine research can directly impact the quality and duration of patients’ lives, and emergency physicians strive every day to enhance the quality and quantity of their patients’ lives,” said Dr. Charles B. Cairns, professor and chair of the University of North Carolina School of Medicine’s department of emergency medicine and ACEP/SAEM Task Force co-chair.

“Now, with the NIH’s interest in supporting patient-focused research, we’ll have a formal research structure to address some of the key issues affecting their practice,” he said.

The federally funded program “is a major step forward, and it reflects the sincerity of the NIH’s commitment, especially in these difficult financial times, to support emergency care research,” said Dr. Roger J. Lewis, professor of medicine at Harbor-UCLA Medical Center’s department of emergency medicine and ACEP/SAEM Task Force co-chair.

‘for emergency medicine to have a major initiative within the NIH is a remarkable accomplishment for our field.’

Dr. Robert W. Neumar, associate professor of emergency medicine at the University of Pennsylvania’s School of Medicine and ACEP/SAEM Task Force member, agreed.

“This is the first NIH funding initiative specifically targeted to emergency care research, and we believe this is a landmark event and the first tangible evidence that the efforts we’ve engaged in over the past 5 years are paying off,” Dr. Neumar said.

Earlier this year, task force members met with Dr. Francis S. Collins, NIH Director, to continue discussions about emergency medicine research that originated at individual NIH institutes during the 2005 ACEP Scientific Assembly in Washington, D.C.

“Emergency physicians can take to heart that the NIH is listening to actual practicing emergency physicians regarding what kind of research we need to be doing in the future to improve the quality of care provided to our patients,” said Dr. Lewis, adding that the NIH is going to great lengths to address areas of concern, such as exactly which institute or center emergency care research falls under at the NIH.

“For example, consider a patient in uncompensated shock for which it’s unclear whether that shock is hemorrhagic, infectious, or has another etiology,” Dr. Lewis said. “In general, the NIH’s structure hasn’t allowed research into the evaluation and treatment of such patients because it doesn’t naturally fall into any specific institute or center within the NIH.

“One of the important things coming out of our meeting with the NIH was an acknowledgment that research into the evaluation and treatment of patients with undifferentiated signs and symptoms is a high priority and will lead to improved emergency care,” Dr. Lewis continued. “Now we must wait for the outcome of an ongoing internal NIH process through which they’re working to identify the best administrative structure for supporting emergency care research.”

According to Dr. Cairns, there are several actions that ACEP members can take to further the field of emergency medicine research in the meantime.

“Now that it’s obvious that we have the attention of the NIH leadership and that the NIH is making significant investments in emergency care research and emergency medicine physician investigators, we need to get word out to the leaderships of residency programs and academic departments of emergency medicine to fill the pipeline,” Dr. Cairns said. “Our field attracts extremely talented, productive, and accomplished students and residents, and we need to help funnel them toward research training.”

In addition, according to Dr. Cairns, emergency physicians need to recognize that an NIH investment in emergency care research means that emergency physicians “have a responsibility” to start identifying and addressing the key problems and challenges facing the field, including time-sensitive care and patients with life-threatening conditions, as well as efforts to optimize efficiency and resource utilization in the emergency care system.

“Finally, we should recognize all those who supported these efforts,” Dr. Cairns said. “To have the NIH take this on as a major initiative required not just input from ACEP, SAEM, and other key emergency medicine groups, but also internal support from NIH staff and scientists who understand the value of emergency care and were willing to champion the effort. The NIH is one of the world’s largest research organizations with over $30 billion a year in annual funding, so for emergency medicine to have a major initiative within the NIH is a remarkable accomplishment for our field."