Clinical trial NCT06335940: Admission for Respiratory Disease And VIdeo Regulation System
Official title: Admission for Respiratory Disease And VIdeo Regulation System
Study type: OBSERVATIONAL
Overall status: NOT_YET_RECRUITING
Conditions: Pediatric Respiratory Diseases
Keywords: Videoregulation
Dispatch
Lead sponsor: University Hospital, Grenoble
Sponsor class: OTHER
First posted: 2024-03-28
Enrollment: 588
Sex: ALL
Maximum age (years): 10
Standard ages: CHILD
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Patients included in this study will be children strictly under 10 years of age whose parents have called the SAMU38 for respiratory difficulties.

Therefore, patients who received ambulatory medical advice (with or without instructions to consult a general practitioner within a defined period of time), who were referred to the emergency service by their own means or who benefited from a first-aid vector (fire department or private ambulance) will be included.

Brief summary: Pediatric dyspnea is a major health problem, accounting for up to 27% of admissions to emergency departments in winter. It is estimated that a significant number (13%) of patients presenting to emergency departments are outpatients, at a time when emergency departments are having to cope with an ever-increasing flow of patients.

Proper referral of patients calling the SAMU Centre-15 takes on its full meaning in this context, but regulating paediatric calls is more difficult. Indeed, the regulating doctor is most often in contact with the parents, who describe what they see and pass on their concerns, and it is difficult to have direct contact with patients who are often very young. Obtaining objective criteria such as saturation and respiratory rate is also a real challenge.

To overcome the complexity of medical regulation, a number of tools and aids have been developed, including visio or video-regulation (regulation via the camera on the caller's smartphone).

This device has been evaluated in a number of situations, enabling it to take its place in the daily practice of many doctors, but there is very little data concerning pediatric visio-regulation, particularly with regard to dyspnea.

To the best of the investigator knowledge, there is no prospective study looking at the impact of Video-Regulation on the outcome of patients requiring the advice of SAMU Centre-15 for pediatric dyspnea.


Eligibility criteria: Inclusion Criteria:

* Age strictly less than 10 years
* Applicant calling the SAMU38 for a child with dyspnea announced or presumed by the interrogation.
* Patients for whom no opposition from parents has been obtained.
* Patients affiliated to social security

Exclusion Criteria:

* Call to organize a secondary intervention (or Inter-Hospital Transfer (TIH/TIIH)).
* Unsuccessful call (hung up when the dispatcher took the call, without the possibility of medical regulation).
* Refusal to take charge on arrival of rescue vector
* Call-back for a patient with an initial call to SAMU38 \< 48h
* Means engaged by the CTA or an ARM even before medical regulation.

Primary outcomes:
measure: To determine in children under 10 years of age for whom a call to the SAMU38 for dyspnea is made, whether the use of Visio-Regulation reduces the percentage of emergency room admissions compared with standard telephone medical regulation.
timeFrame: 24 hours
Secondary outcomes:
measure: Evaluate whether the use of video-regulation has an impact on the dispatcher's referral decision between ambulatory medicine and the emergency department.
timeFrame: through call completion, an average of 5 minutes
measure: Determine whether the use of video-regulation leads to an increase in call time with the regulating doctor
timeFrame: through call completion, an average of 5 minutes
measure: Evaluate parents' satisfaction with videoregulation compared with a standard call
timeFrame: 15 days
measure: Evaluate the number of rescue vectors (fire brigade, private ambulance) triggered but whose decision will ultimately be to "leave on the spot" after the rescue worker's assessment.
timeFrame: through out-of-hospital care completion, an average of 1 hour
measure: Evaluate whether the increased use of video-regulation is not associated with a higher rate of hospitalization in a conventional ward or intensive care unit
timeFrame: 24 hours
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