• Resuscitation · May 2012

    Teleconsultation in pre-hospital emergency medical services: real-time telemedical support in a prospective controlled simulation study.

    • Max Skorning, Sebastian Bergrath, Daniel Rörtgen, Stefan K Beckers, Jörg C Brokmann, Benjamin Gillmann, Jöran Herding, Michael Protogerakis, Christina Fitzner, Rolf Rossaint, and Med-on-@ix-Working Group.
    • Department of Anaesthesiology, University Hospital Aachen, RWTH Aachen University, D-52057 Aachen, Germany. mskorning@ukaachen.de
    • Resuscitation. 2012 May 1;83(5):626-32.

    BackgroundTeleconsultation from the scene of an emergency to an experienced physician including real-time transmission of monitoring, audio and visual information seems to be feasible. In preparation for bringing such a system into practice within the research project "Med-on-@ix", a simulation study has been conducted to investigate whether telemedical assistance (TMA) in Emergency Medical Services (EMS) has an impact on compatibility to guidelines and timing.Material And MethodsIn a controlled simulation study 29 EMS teams (one EMS physician, two paramedics) ran through standardized scenarios (STEMI: ST-elevation myocardial infarction; MT: major trauma) on high-fidelity patient simulators with defined complications (treatable clearly following guidelines). Team assignments were randomized and each team had to complete one scenario with and another without TMA. Analysis was based on videotaped scenarios using pre-defined scoring items and measured time intervals for each scenario.ResultsAdherence to treatment algorithms improved using TMA. STEMI: cathlab informed (9/14 vs. 15/15; p=0.0169); allergies checked prior to acetylsalicylic acid (5/14 vs. 13/15; p=0.0078); analgosedation prior to cardioversion (10/14 vs. 15/15; p=0.0421); synchronized shock (6/14 vs. 14/15; p=0.0052). MT: adequate medication for intubation (3/15 vs. 10/14; p=0.0092); mean time to inform trauma centre 547 vs. 189 s (p=0.0001). No significant impairment of performance was detected in TMA groups.ConclusionsIn simulated setting TMA was able to improve treatment and safety without decline in timing. Nevertheless, further research is necessary to optimize the system for medical, organizational and technical reasons prior to the evaluation of this system in routine EMS.Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

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