Acute Stroke
Conditions
Keywords
stroke, teleconsultation, telemedicine, emergency medical service
Brief summary
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.
Detailed description
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.
Interventions
PROCEDURETeleconsultation
Teleconsultation of an EMS physician in cases of suspected acute stroke
Sponsors
RWTH Aachen University
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* suspected acute stroke * verbal consent for teleconsultation obtained or patient is not able to consent due to the severity of the emergency
Exclusion criteria
* no suspected stroke * patient refuses consent
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Quality of prehospital care | average 1 hour | Analysis of the quality of prehospital care on the basis of published guidelines for acute stroke |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Clinical time intervals | 12 hours | Prehospital and in-hospital time intervals: on-scene-time, contact to hospital time, door (hospital) to cerebral imaging, door (hospital) to thrombolysis |
| Diagnostic quality | up to 28 days | Comparison of prehospital and definitive diagnosis |
| Information transfer | 2 hours | Amount of stroke specific information that is transferred to the admitting hospital. |
| choice of appropriate hospital | average 1 hour | Evaluation how many patients are transported to an appropriate facility (stroke unit) |
Countries
Germany
Outcome results
None listed