Prehospital Emergency Care of Obstructive Respiratory Emergencies With the Use of Teleconsultation

Study Overview
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Brief Summary
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The aim of the study is to investigate the quality of prehospital emergency care in acute respiratory emergencies, when paramedics are supported telemedically by an EMS physician.

Detailed Description
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Six ambulances from five different Emergency Medical Service (EMS) districts are equipped with a portable telemedicine system. In cases of acute obstructive, respiratory emergencies the paramedics can use this system to contact a so called tele-EMS physician after consent of the patient was 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. The transmission of still pictures (taken with a smartphone), 12-lead-ECGs and video streaming from the inside of the ambulance can also be carried out, if indicated. The tele-EMS physician supports the EMS team in obtaining all relevant medical history, 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.

Official Title
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Prehospital Emergency Care of Obstructive Respiratory Emergencies With the Use of Teleconsultation

Conditions
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Asthma, COPD

Intervention / Treatment
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* Device: Teleconsultation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Obstructive, respiratory emergency Verbal consent for teleconsultation obtained or patient is not able to consent due the severity of the emergency Exclusion Criteria: No respiratory emergency Refused consent for teleconsultation
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Device: Teleconsultation<br>In cases of acute obstructive, respiratory emergencies if patients give informed consent the paramedics can use this system to contact a so called tele-EMS physician who has an audio-connection to the EMS team and receives vital parameters (e.g., ECG, pulse oximetry, non-invasive blood pressure) in real-time. The transmission of still pictures (taken with a smartphone), 12-lead-ECGs and video streaming from the inside of the ambulance can also be carried out, if indicated. The tele-EMS physician supports the EMS team in obtaining all relevant medical history, 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. | Device: Teleconsultation<br>* Teleconsultation for the EMS in acute respiratory emergencies<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Oxygen Saturation | Measurement of pulse oximetric oxygen saturation at the timepoint of first contact with a physician (EMS physician OR hospital arrival) | average 1 hour | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Quality of emergency care | Analysis of the quality of prehospital care on the basis of published guidelines for asthma / COPD. | average 1 hour | 
| Rate of ventilation | Fraction of patients that receive invasive or non-invasive ventilation during the prehospital phase | average 1 hour | 
| Rate of complications | Rate of complications due to medications: allergic reaction, heart rhythm problems | 2 hours | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Asthma, COPD, emergency medical service, teleconsultation, telemedicine