The Pennsylvania Consortium for Emergency Research will leverage our experience and infrastructure to participate in the Strategies to Innovate EmeRgENcy Care Clinical Trials Network (SIREN). The University of Pittsburgh will act as a Hub with strong academic and clinical partners at the Thomas Jefferson University, Allegheny Health Network, and the Pennsylvania State University. Each partner is affiliated with a health system that can provide additional clinical sites within the region for future growth. This geographically tight collaboration, with access to emergency patients and emergency medical services in rural, suburban and urban parts of Pennsylvania, will participate in network emergency care trials with the following Aims: (1) Provide administrative structure to rapidly implement and enroll in clinical trials of emergency treatments. (2) Minimize time, cost and regulatory barriers to multicenter clinical trials in emergency settings. (3) Explore innovative strategies to increase identification, recruitment, and consent in emergency treatment trials. (4) Explore innovative strategies to increase quality of emergency care data and to ensure retention of subjects enrolled in emergency settings. The investigators have established working relationships to conduct clinical trials and are leaders in cardiac and neurological emergencies. Through experience in prior research networks and investigator initiated research, this site has created efficient research staffing models, toolkits and telemedicine approaches to emergency informed consent, novel mobile health strategies for subject retention, special skill with prehospital electronic data, and unique integration of critical care and emergency medicine. These efficiencies and innovations will be shared and are scalable for SIREN.