Asthma, Bronchial Hyperreactivity, Bronchiolitis, Croup, Croup; False, Pneumonia, Respiratory Distress Syndrome
Conditions
Keywords
Telemedicine, Respiratory distress, Pediatric, General practitioner
Brief summary
Pediatrician does physical examination through telemedicine and in real life to see whether the telemedicine consultation corresponds with the real life examination. Goal is to determine: 1. Check practical feasability 2. Check whether there are no great objections for a larger study (ie. in case telemedicine consultation is much more unreliable to do a physical examination a larger study is deemed unsafe)
Detailed description
40 pediatric patients seen by a general practitioner (GP) whom the GP has referred or wants to refer to a pediatrician for clinical evaluation are included in this study. Study is designed in 2 parts. Part 1 is at the emergency room in the hospital Part 2 is at the GPs office The pediatrician sees the patient through a telemedicine consultation. Then sees the patient in real life to see if what was seen during telemedicine corresponds with the real life consultation. With telemedicine and real life consultation the pediatrician rates the patient as either a candidate to go home or to be admitted. With the telemedicine consultation there is also an option in doubt: i want to see the patient in real life. Also with both telemedicine and real life examination the pediatrician scores the patient using the respiratory observation scale (Siew et al, 2016) Goal is to: 1. Check practical feasability 2. Check whether there are no great objections for a larger study (ie. in case telemedicine consultation is much harder to do a physical examination
Interventions
DEVICETelemedicine
Patient is examined using telemedicine
Sponsors
Rijnstate Hospital
Study design
Observational model
CASE_ONLY
Time perspective
CROSS_SECTIONAL
Eligibility
Sex/Gender
ALL
Age
3 Months to 18 Years
Healthy volunteers
No
Inclusion criteria
* Pediatric patients with respiratory symptoms whom are referred by a general practitioner to be evaluated by a pediatrician
Exclusion criteria
* Infants younger than 2 months of age * 19 years and older * Ex-premature with post-conceptional age \<48 weeks * Congenital heart disease * Down Syndrome * Immune deficiency * Pre-existent pulmonary disorder (Broncho-pulmonary dysplasia, Cystic Fibrosis) * Pre-existent neurological disorders * Apnea's * Patients with respiratory distress with dehydration symptoms * Patients who have already been treated with salbutamol inhalers of nebulizer - Emergency patient with respiratory insufficiency * Technical problems which cause a delay longer than 10 minutes before a video-connection is made * expected delay before commencing telemedicine consultation of longer than 30 minutes
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Discharge or admitted? | within 30-60 minutes after inclusion | Patients are categorized in one of three categories through telemedicine-evaluation Group 1: Patient can safely go home Group 2: Patient will need to be admitted Group 3: In doubt between group 1 and group 2, emergency room consultation required FTF evaluation: Group 1: Patient can safely go home Group 2: Patient will need to be admitted |
| Respiratory Observation Scale | within 30-60 minutes after inclusion | Observe the presence of: tachypnea, nasal flaring, perioral cyanosis, tripoding, thoracoabdominal asynchrony, supraclavicular-, substernal- or intercostal retractions, mental status and patient in respiratory distress |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Patient reported experience measure | within 60 minutes after telemedicine evaluation | questionnaire on patient / parent satisfaction with regard to the telemedicine |
| Doctor reported experience measure | within 4 weeks after inclusion of patients | Interview with participating doctors with regard to satisfaction of the telemedicine |
Contacts
Primary ContactMendel Ottow, Drs, MD
Backup ContactMargreet Wessels, MD, PhD
Outcome results
None listed