Comparison of physician staffed emergency teams with paramedic teams assisted by telemedicine - a randomized, controlled simulation study
Rortgen D et al. – Telemedically assisted paramedic care was feasible and at least not inferior compared to standard Emergency Medical Services (EMS) teams with a physician on–scene in these scenarios.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.
- 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.