Telemedical vs. Conventional Prehospital Care in Acute Coronary Syndromes

Study Overview
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Brief Summary
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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.

Detailed Description
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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. All data was collected prospectively for quality management purposes and analyzed retrospectively after ethical approval by the local ethics committee.

Official Title
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Quality Outcomes in Acute Coronary Syndromes Between Telemedically Supported Paramedics and Conventional On-scene Physician Care

Conditions
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Acute Coronary Syndrome

Intervention / Treatment
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* Procedure: Telemedical support


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: symptoms of acute coronary syndrome - Exclusion Criteria: secondary transfers from hospital to hospital, traumatic chest pain -

Ages Eligible for Study
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Minimum Age: 18 Years

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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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Telemedicine group<br>Telemedical care of acute coronary syndromes in the prehospital phase. Paramedics were supported by a physician in a tele consultation centre. | Procedure: Telemedical support<br>* Telemedical support by a physician in a telemedicine centre<br>|
| Control group<br>Conventional on-scene care of acute coronary syndromes by a physician. No telemedicine system was available during this control period. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Adverse events | respiratory / circulatory insufficiency, allergic reaction, cardiac arrest | prehospital phase (0.5-2 hours) | 

Secondary Outcome Measures

| Outcome Measure | 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 | 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) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Non-STEMI Acute Coronary Syndrome, ST-segment elevation myocardial infarction, Telemedicine