Telemedical Support in Prehospital Emergency Care of Acute Coronary Syndromes
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 39
- 试验地点
- 1
- 主要终点
- Quality of prehospital care
研究概览
简要总结
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.
详细描述
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.
研究设计
- 研究类型
- Interventional
- 分配方式
- Non Randomized
- 干预模型
- Single Group
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Suspected acute coronary syndrome
- •Verbal consent for teleconsultation obtained or patient is not able to consent due to the severity of the emergency
排除标准
- •Patient refuses consent to teleconsultation
- •No suspected acute coronary syndrome
研究组 & 干预措施
Device: 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.
干预措施: Teleconsultation (Procedure)
Historical Matched Pairs
Historical matched pairs were searched from local protocols. During this phase no teleconsultation system was existent.
结局指标
主要结局
Quality of prehospital care
时间窗: average 1 hour
Analysis of the quality of the prehospital care on the basis of published guidelines for ACS / STEMI
次要结局
- Inhospital time intervals in STEMI(up to 12 hours)
- Conducted procedures and medications (paramedics)(average 1 hour)
- prehospital time intervals(average 1 hour)
- Troponin-Level(24 hours)
- Rate of secondary transfer for PCI(up to 7 days)