Clinical trial NCT01644006: Telemedical Support in Prehospital Emergency Care of Acute Coronary Syndrome
Official title: Telemedical Support in Prehospital Emergency Care of Acute Coronary Syndromes
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Acute Coronary Syndrome
Keywords: acute coronary syndrome
telemedicine
teleconsultation
emergency medical service
Lead sponsor: RWTH Aachen University
Sponsor class: OTHER
First posted: 2012-07-18
Enrollment: 39
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NON_RANDOMIZED
Intervention model: SINGLE_GROUP
Primary purpose: TREATMENT

Brief summary: The aim of the study is to investigate the quality of prehospital emergency care in acute coronary syndromes, when paramedics are supported telemedically by an EMS physician.

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 criteria: 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

Primary outcomes:
measure: Quality of prehospital care
timeFrame: average 1 hour
Secondary outcomes:
measure: Inhospital time intervals in STEMI
timeFrame: up to 12 hours
measure: Rate of secondary transfer for PCI
timeFrame: up to 7 days
measure: Troponin-Level
timeFrame: 24 hours
measure: Conducted procedures and medications (paramedics)
timeFrame: average 1 hour
measure: prehospital time intervals
timeFrame: average 1 hour
Other outcomes:
Locations:
city: Aachen
country: Germany
facility: University Hospital Aachen
Study officials:
affiliation: University Hospital Aachen, Germany, Department of Anesthesiology
name: Rolf Rossaint, Prof. Dr.
role: STUDY_CHAIR
affiliation: University Hospital Aachen, Germany, Emergency Department
name: Jörg C Brokmann, Dr.
role: PRINCIPAL_INVESTIGATOR
References:
citation: Brokmann JC, Conrad C, Rossaint R, Bergrath S, Beckers SK, Tamm M, Czaplik M, Hirsch F. Treatment of Acute Coronary Syndrome by Telemedically Supported Paramedics Compared With Physician-Based Treatment: A Prospective, Interventional, Multicenter Trial. J Med Internet Res. 2016 Dec 1;18(12):e314. doi: 10.2196/jmir.6358.