The aim of the study is to investigate the quality of prehospital emergency care in acute stroke, when paramedics are supported telemedically by an EMS physician.
Six ambulances from five different Emergency Medical Service (EMS) districts are equipped with a portable telemedicine system. In cases of suspected acute stroke (including intracranial hemorrhage), 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. 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, neurological 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.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
28
Teleconsultation of an EMS physician in cases of suspected acute stroke
University Hospital Aachen
Aachen, Germany
Quality of prehospital care
Analysis of the quality of prehospital care on the basis of published guidelines for acute stroke
Time frame: average 1 hour
Clinical time intervals
Prehospital and in-hospital time intervals: on-scene-time, contact to hospital time, door (hospital) to cerebral imaging, door (hospital) to thrombolysis
Time frame: 12 hours
Diagnostic quality
Comparison of prehospital and definitive diagnosis
Time frame: up to 28 days
Information transfer
Amount of stroke specific information that is transferred to the admitting hospital.
Time frame: 2 hours
choice of appropriate hospital
Evaluation how many patients are transported to an appropriate facility (stroke unit)
Time frame: average 1 hour
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