Comparison of physician staffed emergency teams with paramedic teams assisted by telemedicine - a randomized, controlled simulation study

RESUSCITATION

卷:84

Article

Roertgen, Daniel¹  Bergrath, Sebastian¹  Rossaint, Rolf¹  Beckers, Stefan K.^1,2  Fischermann, Harold¹  Na, In-Sik¹  Peters, David¹  Fitzner, Christina³  Skorning, Max¹ 

[1] Rhein Westfal TH Aachen, Univ Hosp Aachen, Dept Anaesthesiol, Sect Emergency Med Care, D-52074 Aachen, Germany

[2] Rhein Westfal TH Aachen, Univ Hosp Aachen, Dept Intens Care Med & Intermediate Care, D-52074 Aachen, Germany

[3] Rhein Westfal TH Aachen, Dept Med Stat, D-52074 Aachen, Germany

关键词: Telemedicine;    Teleconsultation;    Data transmission;    Emergency medical service;    Simulation;    Video analysis;   

DOI  :  10.1016/j.resuscitation.2012.06.012

来源: Elsevier

【 摘 要 】

Purpose and background: Emergency medical services (EMSs) vary considerably. While some are physician staffed, most systems are run by paramedics. The objective of this randomized, controlled simulation study was to compare the emergency care between physician staffed EMS teams (control group) and paramedic teams that were supported telemedically by an EMS physician (telemedicine group). Methods: Overall 16 teams (1 EMS physician, 2 paramedics) were randomized to the control group or the telemedicine group. Telemedical functionalities included two-way audio communication, transmission of vital data (numerical values and curves) and video streaming from the scenario room to the remotely located EMS physician. After a run-in scenario all teams completed four standardized scenarios, in which no highly invasive procedures (e. g. thoracic drain) were required, two using high-fidelity simulation (burn trauma, intoxication) and two using standardized patients (renal colic, barotrauma). All scenarios were videotaped and analyzed by two investigators using predefined scoring items. Results: Non case-specific items (31 vs. 31 scenarios): obtaining of 'symptoms', 'past medical history' and 'events' were carried out comparably, but in the telemedicine group 'allergies' (17 vs. 28, OR 7.69, CI 2.1-27.9, p = 0.002) and 'medications' (17 vs. 27, OR 5.55, CI 1.7-18.0, p = 0.004) were inquired more frequently. No significant differences were found regarding the case-specific items and in both groups no potentially dangerous mistreatments were observed. Conclusion: Telemedically assisted paramedic care was feasible and at least not inferior compared to standard EMS teams with a physician on-scene in these scenarios. (C) 2012 Elsevier Ireland Ltd. All rights reserved.

【 授权许可】

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