Telemedical Versus Conventional Emergency Care of Hypertensive Emergencies

Telemedical Versus Conventional Emergency Care of Hypertensive Emergencies and Urgencies

Comparison of telemedical prehospital emergency care and conventional on-scene physician based care of hypertensive emergencies and urgencies. The adherence to current Guidelines should be researched.

Study Overview

• Status: Completed
• Conditions: Hypertensive Urgency; Hypertensive Emergency
• Intervention / Treatment: Other: Telemedical care

Detailed Description

Telemedically guided cases of hypertensive emergencies (april 2014 - March 2015) and urgencies are compared with a historical control group of conventional emergency medical service physician care on-scene for these scenarios. The historical control group is a time period prior to implementation of the telemedicine system and after a research project with a precursor telemedicine system. No telemedical support but only conventional on-scene EMS physician care was available (November 2013 - March 2014).

• Study Type: Observational
• Enrollment (Actual): 331

Contacts and Locations

Study Locations

• Germany
  • Aachen, Germany, 52074
    • University Hospital Aachen

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

Patients whith a prehospital diagnosis of hypertensive emergency or urgency

Description

Inclusion Criteria:

• prehospital diagnosis of hypertensive emergency of hypertensive urgency

Exclusion Criteria:

Prehospital diagnoses of:

• pulmonary edema
• aortic dissection
• acute coronary syndrome
• acute stroke
• acute respiratory insufficiency

Study Plan

How is the study designed?

Design Details

• Observational Models: Case-Control
• Time Perspectives: Retrospective

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Telemedicine group; Cases of hypertensive emergencies and urgencies in which the prehospital emergency care was performed by on-scene paramedics, guided by a qualified physician in a teleconsultation center.	Other: Telemedical care; Telemedically guided care based on a standard operating procedure
Control group; Historical cases of of hypertensive emergencies and urgencies in which the prehospital emergency care was carried out by on-scene emergency medical service physicians (conventional care).

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
Blood pressure difference between initial contact and emergency room handover	2 hours

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Difference of heart rate between initial contact and emergency room handover		2 hours
Magnitude of blood pressure reduction using categories	To measure guideline adherence blood pressure (BP) reductions were evaluated with four categories: no BP reduction, reduction <= 25%, reduction >25-30%, reduction > 30% (BP difference between initial contact and emergency room handover)	2 hours

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Analysis of administered antihypertensive agents		2 hours
context specific quality of medical history and documentation	Analysis of medical history and vital parameter documentation completeness	2 hours

Collaborators and Investigators

• Sponsor: RWTH Aachen University
• Investigators: Principal Investigator: Jörg Ch Brokmann, Dr. med., University Hospital Aachen, Germany

Study record dates

Study Major Dates

• Study Start: November 1, 2013
• Primary Completion (Actual): March 1, 2015
• Study Completion (Actual): August 1, 2016

Study Registration Dates

• First Submitted: October 3, 2016
• First Submitted That Met QC Criteria: October 3, 2016
• First Posted (Estimate): October 5, 2016

Study Record Updates

• Last Update Posted (Estimate): October 5, 2016
• Last Update Submitted That Met QC Criteria: October 3, 2016
• Last Verified: October 1, 2016

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Pathologic Processes; Cardiovascular Diseases; Vascular Diseases; Disease Attributes; Hypertension; Emergencies; Hypertension, Malignant
• Other Study ID Numbers: tech (Other Identifier: TexasTechU)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: No