Emergency Medical Service, Indication for Analgesia, Teleconsultation
Conditions
Keywords
telemedicine, teleconsultation, analgesia, emergency, prehospital
Brief summary
The aim of the study is to evaluate the safety and efficacy of telemedically supported and delegated pain therapy in the Emergency Medical Service (EMS).
Detailed description
Six ambulances from five different Emergency Medical Service (EMS) districts are equipped with a portable telemedicine system. In cases of emergencies, where intravenous analgesia is necessary, 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 - and video streaming from the inside of the ambulance can be carried out, if meaningful. The tele-EMS physician supports the EMS team and can delegate the application of morphine and other analgesics. 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. All regular ambulances of the five districts are not allowed to administer analgesics without an physician on-scene. They have to call an Advanced Life Support response unit, staffed with an EMS physician, who carries out all kinds of ALS interventions. The safety, efficacy and the quality of analgesia should be compared with regular EMS.
Interventions
OTHERTeleconsultation
Teleconsultation between paramedics and an EMS physician
Sponsors
RWTH Aachen University
Study design
Allocation
NON_RANDOMIZED
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
Inclusion criteria
* Verbal consent obtained or patient is unable to consent due to the severity of the emergency * Indication for analgesia
Exclusion criteria
* Refused consent * No indication for analgesia
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Rate of complications | 2 hours | Definition of complications: respiratory insufficiency, allergic reaction, circulatory insufficiency |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Pain level | average 1 hour | Pain level measured with numerical rating scale |
| Incidence of nausea and vomiting | 2 hours | — |
| Time intervals | average 1 hour | on-scene time, contact to hospital time |
| Medications and dosages | average 1 hour | Evaluation and description of the used medications and dosages |
Countries
Germany
Outcome results
None listed