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| ID | Type | Description | Link |
|---|---|---|---|
| PtJ-Az.: z0909im002b | Other Grant/Funding Number | PTJ |
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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.
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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Device: Teleconsultation | Experimental | 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. |
|
| Historical Matched Pairs | No Intervention | Historical matched pairs were searched from local protocols. During this phase no teleconsultation system was existent. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Teleconsultation | Procedure | Teleconsultation of an EMS physician to support the paramedics in acute coronary syndromes |
|
| Measure | Description | Time Frame |
|---|---|---|
| Quality of prehospital care | Analysis of the quality of the prehospital care on the basis of published guidelines for ACS / STEMI | average 1 hour |
| Measure | Description | Time Frame |
|---|---|---|
| Inhospital time intervals in STEMI | contact to balloon time, arrival to balloon time | up to 12 hours |
| Rate of secondary transfer for PCI | Rate of secondary transfer to a different facility for PCI |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Rolf Rossaint, Prof. Dr. | University Hospital Aachen, Germany, Department of Anesthesiology | Study Chair |
| Jörg C Brokmann, Dr. | University Hospital Aachen, Germany, Emergency Department | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University Hospital Aachen | Aachen | 52074 | Germany |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 27908843 | Derived | Brokmann JC, Conrad C, Rossaint R, Bergrath S, Beckers SK, Tamm M, Czaplik M, Hirsch F. Treatment of Acute Coronary Syndrome by Telemedically Supported Paramedics Compared With Physician-Based Treatment: A Prospective, Interventional, Multicenter Trial. J Med Internet Res. 2016 Dec 1;18(12):e314. doi: 10.2196/jmir.6358. |
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| ID | Term |
|---|---|
| D054058 | Acute Coronary Syndrome |
| ID | Term |
|---|---|
| D017202 | Myocardial Ischemia |
| D006331 | Heart Diseases |
| D002318 | Cardiovascular Diseases |
| D014652 | Vascular Diseases |
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| ID | Term |
|---|---|
| D019114 | Remote Consultation |
| ID | Term |
|---|---|
| D012017 | Referral and Consultation |
| D011364 | Professional Practice |
| D009934 | Organization and Administration |
| D006298 | Health Services Administration |
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| up to 7 days |
| Troponin-Level | Severity of infarction measured with level of Troponin | 24 hours |
| Conducted procedures and medications (paramedics) | Amount of guidelines based procedures and medications carried out by paramedics prior to the contact with a physician. | average 1 hour |
| prehospital time intervals | on-scene time, contact (EMS) to hospital arrival time, transport time | average 1 hour |
| D017216 | Telemedicine |
| D003695 | Delivery of Health Care |
| D010346 | Patient Care Management |