Telemedical Support in Prehospital Emergency Care of Acute Coronary Syndrome
- Conditions
- Acute Coronary Syndrome
- Interventions
- Procedure: Teleconsultation
- Registration Number
- NCT01644006
- Lead Sponsor
- RWTH Aachen University
- Brief Summary
The aim of the study is to investigate the quality of prehospital emergency care in acute coronary syndromes, when paramedics are supported telemedically by an EMS physician.
- Detailed Description
Six ambulances from five different Emergency Medical Service (EMS) districts are equipped with a portable telemedicine system. In cases of suspected acute coronary syndrome (including STEMI), the paramedics can use this system to contact a so called "tele-EMS physician" after consent of the patient is obtained. The tele-EMS physician has an audio-connection to the EMS team and receives vital parameters (e.g., ECG, pulse oximetry, non-invasive blood pressure) in real-time. Also 12-lead-ECGs can transmitted to the tele-EMS physician. The transmission of still pictures - taken with a smartphone - and video streaming from the inside of the ambulance can be carried out, if meaningful. The tele-EMS physician supports the EMS team in obtaining all relevant medical history, ECG diagnosis, general diagnosis and can delegate the application of medications. This can be carried out to bridge the time to the arrival of an EMS physician or in less severe cases without an EMS physician on-scene.
The quality of prehospital care and the possible influences on the initial inhospital phase should be investigated and compared with regular EMS.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 39
- Suspected acute coronary syndrome
- Verbal consent for teleconsultation obtained or patient is not able to consent due to the severity of the emergency
- Patient refuses consent to teleconsultation
- No suspected acute coronary syndrome
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- SINGLE_GROUP
- Arm && Interventions
Group Intervention Description Device: Teleconsultation Teleconsultation In cases of suspected acute coronary syndrome (including STEMI), if patients give informed consent the paramedics can use this system to contact a so called "tele-EMS physician" with audio-connection to the EMS team and receives vital parameters (e.g., ECG, pulse oximetry, non-invasive blood pressure) in real-time. Also 12-lead-ECGs can be transmitted to the tele-EMS physician. The transmission of still pictures - taken with a smartphone - and video streaming from the inside of the ambulance can be carried out, if meaningful. The tele-EMS physician supports the EMS team in obtaining all relevant medical history, ECG diagnosis, general diagnosis and can delegate the application of medications. This can be carried out to bridge the time to the arrival of an EMS physician or in less severe cases without an EMS physician on-scene. The quality of prehospital care and the possible influences on the initial inhospital phase should be investigated and compared with regular EMS.
- Primary Outcome Measures
Name Time Method Quality of prehospital care average 1 hour Analysis of the quality of the prehospital care on the basis of published guidelines for ACS / STEMI
- Secondary Outcome Measures
Name Time Method Inhospital time intervals in STEMI up to 12 hours contact to balloon time, arrival to balloon time
Conducted procedures and medications (paramedics) average 1 hour Amount of guidelines based procedures and medications carried out by paramedics prior to the contact with a physician.
prehospital time intervals average 1 hour on-scene time, contact (EMS) to hospital arrival time, transport time
Troponin-Level 24 hours Severity of infarction measured with level of Troponin
Rate of secondary transfer for PCI up to 7 days Rate of secondary transfer to a different facility for PCI
Trial Locations
- Locations (1)
University Hospital Aachen
🇩🇪Aachen, Germany