International survey finds persistent gaps in ICU crisis preparedness

The European Society of Intensive Care Medicine conducted an online survey between December 2025 and February 2026 to examine ICU professionals’ experiences of stress, adaptation and support needs. It received responses from 627 professionals in 58 countries; 93.6% were based in Europe and 84.1% were physicians. Respondents had a median of 15 years of ICU experience.

Preparedness measures appeared uneven. More than one-quarter (28.4%) reported no real change in their ICU’s crisis readiness, and fewer than one in five reported significant improvement. Fewer than half said their ICU had a protocol to expand capacity beyond 100% bed occupancy (48.2%) or adapted procurement processes for equipment and materials (41.2%). Only 30.0% considered infrastructure and redundancies adequate for a surge, while 21.7% reported clear, effective mechanisms for staff upskilling during a crisis. Nearly half (45.5%) had not participated in emergency simulation or training in the previous two years.

Workforce shortages and sudden increases in patient demand were prominent sources of stress. Respondents also identified needs for scenario-specific education, protocols, decision-support tools, interdisciplinary training and regional coordination. The findings describe respondents’ perceptions, not objectively measured ICU capability; the predominantly European sample may not represent other regions. The survey identifies preparedness gaps but does not test whether specific interventions improve crisis response.