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Comparison of telemedical prehospital emergency care and conventional on-scene physician based care of hypertensive emergencies and urgencies. The adherence to current Guidelines should be researched.
Telemedically guided cases of hypertensive emergencies (april 2014 - March 2015) and urgencies are compared with a historical control group of conventional emergency medical service physician care on-scene for these scenarios. The historical control group is a time period prior to implementation of the telemedicine system and after a research project with a precursor telemedicine system. No telemedical support but only conventional on-scene EMS physician care was available (November 2013 - March 2014).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Telemedicine group | Cases of hypertensive emergencies and urgencies in which the prehospital emergency care was performed by on-scene paramedics, guided by a qualified physician in a teleconsultation center. |
| |
| Control group | Historical cases of of hypertensive emergencies and urgencies in which the prehospital emergency care was carried out by on-scene emergency medical service physicians (conventional care). |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Telemedical care | Other | Telemedically guided care based on a standard operating procedure |
|
| Measure | Description | Time Frame |
|---|---|---|
| Blood pressure difference between initial contact and emergency room handover | 2 hours |
| Measure | Description | Time Frame |
|---|---|---|
| Difference of heart rate between initial contact and emergency room handover | 2 hours | |
| Magnitude of blood pressure reduction using categories | To measure guideline adherence blood pressure (BP) reductions were evaluated with four categories: no BP reduction, reduction <= 25%, reduction >25-30%, reduction > 30% (BP difference between initial contact and emergency room handover) |
| Measure | Description | Time Frame |
|---|---|---|
| Analysis of administered antihypertensive agents | 2 hours | |
| context specific quality of medical history and documentation | Analysis of medical history and vital parameter documentation completeness | 2 hours |
Inclusion Criteria:
Exclusion Criteria:
Prehospital diagnoses of:
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Patients whith a prehospital diagnosis of hypertensive emergency or urgency
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| Name | Affiliation | Role |
|---|---|---|
| Jörg Ch Brokmann, Dr. med. | University Hospital Aachen, Germany | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University Hospital Aachen | Aachen | 52074 | Germany |
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| ID | Term |
|---|---|
| D000096003 | Hypertensive Crisis |
| ID | Term |
|---|---|
| D006973 | Hypertension |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
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| 2 hours |