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Telemedically supported paramedic care of acute coronary syndromes was compared to a historical control period of solely conventional on-scene physician care. Quality outcomes based on current guidelines were researched als well as time requirements in both groups.
Telemedically supported paramedic care of acute coronary syndromes was compared to a historical control period of solely conventional on-scene physician care. Quality outcomes based on current guidelines were researched als well as time requirements in both groups. All data was collected prospectively for quality management purposes and analyzed retrospectively after ethical approval by the local ethics committee.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Telemedicine group | Telemedical care of acute coronary syndromes in the prehospital phase. Paramedics were supported by a physician in a tele consultation centre. |
| |
| Control group | Conventional on-scene care of acute coronary syndromes by a physician. No telemedicine system was available during this control period. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Telemedical support | Procedure | Telemedical support by a physician in a telemedicine centre |
|
| Measure | Description | Time Frame |
|---|---|---|
| Adverse events | respiratory / circulatory insufficiency, allergic reaction, cardiac arrest | prehospital phase (0.5-2 hours) |
| Measure | Description | Time Frame |
|---|---|---|
| Correct use of Aspirin | Correct use of Aspirin based on current guidelines | prehospital phase (0.5-2 hours) |
| Correct use of unfractionated Heparin (UFH) | Correct use of UFH based on current guidelines |
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Inclusion Criteria: symptoms of acute coronary syndrome -
Exclusion Criteria: secondary transfers from hospital to hospital, traumatic chest pain
-
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Patients who called the emergency medical service and the paramedics suspect acute coronary syndrome.
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University Hospital Aachen | Aachen | 52074 | Germany |
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| ID | Term |
|---|---|
| D054058 | Acute Coronary Syndrome |
| D000072657 | ST Elevation Myocardial Infarction |
| ID | Term |
|---|---|
| D017202 | Myocardial Ischemia |
| D006331 | Heart Diseases |
| D002318 | Cardiovascular Diseases |
| D014652 | Vascular Diseases |
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| prehospital phase (0.5-2 hours) |
| Correct use of Morphine | Correct use of Morphine based on current guidelines | prehospital phase (0.5-2 hours) |
| Use of 12-lead-ECG | Use of 12-lead-ECG after first medical contact | prehospital phase (0.5-2 hours) |
| Correct transport destination | hospital with cath lab in ST-segment elevation myocardial infarction or high-risk Non-STEMI-ACS | prehospital phase (0.5-2 hours) |
| Correct use of oxygen | Correct use of Morphine based on current guidelines | prehospital phase (0.5-2 hours) |
| Correct use of Glyceroltrinitrate | Correct use of Glyceroltrinitrate based on current guidelines | prehospital phase (0.5-2 hours) |
| D009203 |
| Myocardial Infarction |
| D007238 | Infarction |
| D007511 | Ischemia |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D009336 | Necrosis |