Prehospital Telemedical Support in Acute Stroke

Not Applicable

Completed

• Conditions: Acute Stroke
• Interventions: Procedure: Teleconsultation

• Registration Number: NCT01644019
• Lead Sponsor: RWTH Aachen University

Brief Summary

The aim of the study is to investigate the quality of prehospital emergency care in acute stroke, 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 stroke (including intracranial hemorrhage), 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. The transmission of still pictures (taken with a smartphone), 12-lead-ECGs and video streaming from the inside of the ambulance can also be carried out, if indicated. The tele-EMS physician supports the EMS team in obtaining all relevant medical history, neurological 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.

Study Timeline

• Study First Submitted: 2012-07-12
• Study First Submitted QC: 2012-07-16
• Study First Posted: 2012-07-18
• Study Start: 2012-08
• Primary Completion: 2013-07
• Status Verified: 2015-09
• Study Completion: 2015-09
• Last Update Submitted: 2015-09-21
• Last Update Posted: 2015-09-22

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 28

Inclusion Criteria

• suspected acute stroke
• verbal consent for teleconsultation obtained or patient is not able to consent due to the severity of the emergency

Exclusion Criteria

• no suspected stroke
• patient refuses consent

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: SINGLE_GROUP

Arm && Interventions

Group	Intervention	Description
Device: Teleconsultation	Teleconsultation	In cases of suspected acute stroke (including intracranial hemorrhage), if patients give informed consent the paramedics can use this system to contact a so called "tele-EMS physician" who has an audio-connection to the EMS team and receives vital parameters (e.g., ECG, pulse oximetry, non-invasive blood pressure) in real-time. The transmission of still pictures (taken with a smartphone), 12-lead-ECGs and video streaming from the inside of the ambulance can also be carried out, if indicated. The tele-EMS physician supports the EMS team in obtaining all relevant medical history, neurological 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 prehospital care on the basis of published guidelines for acute stroke

Secondary Outcome Measures

Name	Time	Method
Clinical time intervals	12 hours	Prehospital and in-hospital time intervals: on-scene-time, contact to hospital time, door (hospital) to cerebral imaging, door (hospital) to thrombolysis
Information transfer	2 hours	Amount of stroke specific information that is transferred to the admitting hospital.
choice of appropriate hospital	average 1 hour	Evaluation how many patients are transported to an appropriate facility (stroke unit)
Diagnostic quality	up to 28 days	Comparison of prehospital and definitive diagnosis

Trial Locations

Locations (1)

University Hospital Aachen; 🇩🇪 Aachen, Germany