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Telemedical Support in Prehospital Emergency Care of Acute Coronary Syndrome
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Purpose
| Condition | Intervention |
|---|---|
| Acute Coronary Syndrome | Procedure: Teleconsultation |
| Study Type: | Interventional |
| Study Design: | Allocation: Non-Randomized Intervention Model: Single Group Assignment Masking: None (Open Label) Primary Purpose: Treatment |
| Official Title: | Telemedical Support in Prehospital Emergency Care of Acute Coronary Syndromes |
- Quality of prehospital care [ Time Frame: average 1 hour ]Analysis of the quality of the prehospital care on the basis of published guidelines for ACS / STEMI
- Inhospital time intervals in STEMI [ Time Frame: up to 12 hours ]contact to balloon time, arrival to balloon time
- Rate of secondary transfer for PCI [ Time Frame: up to 7 days ]Rate of secondary transfer to a different facility for PCI
- Troponin-Level [ Time Frame: 24 hours ]Severity of infarction measured with level of Troponin
- Conducted procedures and medications (paramedics) [ Time Frame: average 1 hour ]Amount of guidelines based procedures and medications carried out by paramedics prior to the contact with a physician.
- prehospital time intervals [ Time Frame: average 1 hour ]on-scene time, contact (EMS) to hospital arrival time, transport time
| Enrollment: | 39 |
| Study Start Date: | August 2012 |
| Study Completion Date: | September 2015 |
| Primary Completion Date: | July 2013 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: 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. |
Procedure: Teleconsultation
Teleconsultation of an EMS physician to support the paramedics in acute coronary syndromes
|
|
No Intervention: Historical Matched Pairs
Historical matched pairs were searched from local protocols. During this phase no teleconsultation system was existent.
|
Detailed Description:
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.
Eligibility| Ages Eligible for Study: | 18 Years and older (Adult, Senior) |
| Sexes Eligible for Study: | All |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Suspected acute coronary syndrome
- Verbal consent for teleconsultation obtained or patient is not able to consent due to the severity of the emergency
Exclusion Criteria:
- Patient refuses consent to teleconsultation
- No suspected acute coronary syndrome
Contacts and LocationsPlease refer to this study by its ClinicalTrials.gov identifier: NCT01644006
| Germany | |
| University Hospital Aachen | |
| Aachen, Germany, 52074 | |
| Study Chair: | Rolf Rossaint, Prof. Dr. | University Hospital Aachen, Germany, Department of Anesthesiology |
| Principal Investigator: | Jörg C Brokmann, Dr. | University Hospital Aachen, Germany, Emergency Department |
More Information
Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
| Responsible Party: | RWTH Aachen University |
| ClinicalTrials.gov Identifier: | NCT01644006 History of Changes |
| Other Study ID Numbers: |
005-1003-0034-1 PtJ-Az.: z0909im002b ( Other Grant/Funding Number: PTJ ) |
| Study First Received: | July 12, 2012 |
| Last Updated: | September 21, 2015 |
Keywords provided by RWTH Aachen University:
|
acute coronary syndrome telemedicine teleconsultation emergency medical service |
Additional relevant MeSH terms:
|
Syndrome Emergencies Acute Coronary Syndrome Disease Pathologic Processes |
Disease Attributes Myocardial Ischemia Heart Diseases Cardiovascular Diseases Vascular Diseases |
ClinicalTrials.gov processed this record on September 21, 2017