Comparison of Analgesic Treatment Quality Between Prehospital Emergency Care of Telemedically Guided Paramedics and On-scene Physicians - a Retrospective Longitudinal Study
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 381
- 试验地点
- 1
- 主要终点
- Quality of analgesia
研究概览
简要总结
The purpose of this retrospective study is to analyze quality and adverse events of analgesia by telemedically supported paramedics in comparison to conventional treatment by on-scene emergency medical service (EMS) physicians in the EMS of the city of Aachen, Germany.
详细描述
The standard emergency medical service (EMS) in Germany consists of a two-tiered system with ambulances (paramedics) and prehospital EMS physician units. For example, legal conditions restrict opioid-based analgesia to physicians. Based on pre-defined standards regional emergency dispatch centers deploy both kinds of emergency units.
In recent years telemedicine emerged as a complementary system in EMS that may provide remote medical expertise and sustain or even improve quality of medical treatment on-scene. Particularly, based on the results of the projects Med-on-@ix and TemRas (telemedical rescue assistance system), emergency telemedical services were gradually implemented in daily routine of the EMS of the city of Aachen, Germany.
In this retrospective study the quality and adverse events of analgesia by telemedically supported paramedics shall be compared to conventional treatment by on-scene EMS physicians in the EMS of the city of Aachen, Germany.
研究设计
- 研究类型
- Observational
- 观察模型
- Case Control
- 时间视角
- Retrospective
入排标准
- 年龄范围
- 1 Year 至 —（Child, Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Initial Numerical Rating Scale ≥ 5 and
- •Documented administration of analgesics
排除标准
- •Missing consent for telemedical consultation (in teleconsultation group)
- •Initial NRS < 5
- •Analgesia in non-ST-segment elevation acute coronary syndrome (Non-STEMI-ACS) and ST-elevating myocardial infarction (STEMI)
- •Initially unconscious patient
- •Inter-hospital transfer missions
- •Cases involving both on-scene and telemedical-EMS physicians
结局指标
主要结局
Quality of analgesia
时间窗: Time span of the respective prehospital emergency case treatment; on average a time interval of 30 - 120 minutes for each case.
Decrease of value on the Numerical Rating Scale (NRS; 0-10). The NRS is applied at initial contact with the patient and at the end of the mission.
次要结局
- Administered analgesics and their dosages(Time span of the respective prehospital emergency case treatment; on average a time interval of 30 - 120 minutes for each case.)
- Rate of adverse events(Time span of the respective prehospital emergency case treatment; on average a time interval of 30 - 120 minutes for each case.)
- Number of patients with documented analgesia related (safety-) parameters (evaluated for each safety parameter separately)(Time span of the respective prehospital emergency case treatment; on average a time interval of 30 - 120 minutes for each case.)
- Occurrence of nausea and vomiting(Time span of the respective prehospital emergency case treatment; on average a time interval of 30 - 120 minutes for each case.)