Telemedical vs. Conventional Prehospital Care in Acute Coronary Syndromes

Quality Outcomes in Acute Coronary Syndromes Between Telemedically Supported Paramedics and Conventional On-scene Physician Care

Telemedically supported paramedic care of acute coronary syndromes was compared to a historical control period of solely conventional on-scene physician care. Quality outcomes based on current guidelines were researched als well as time requirements in both groups.

Study Overview

• Status: Completed
• Conditions: Acute Coronary Syndrome
• Intervention / Treatment: Procedure: Telemedical support

Detailed Description

Telemedically supported paramedic care of acute coronary syndromes was compared to a historical control period of solely conventional on-scene physician care. Quality outcomes based on current guidelines were researched als well as time requirements in both groups. All data was collected prospectively for quality management purposes and analyzed retrospectively after ethical approval by the local ethics committee.

• Study Type: Observational
• Enrollment (Actual): 221

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 who called the emergency medical service and the paramedics suspect acute coronary syndrome.

Description

Inclusion Criteria: symptoms of acute coronary syndrome -

Exclusion Criteria: secondary transfers from hospital to hospital, traumatic chest pain

-

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Telemedicine group; Telemedical care of acute coronary syndromes in the prehospital phase. Paramedics were supported by a physician in a tele consultation centre.	Procedure: Telemedical support; Telemedical support by a physician in a telemedicine centre
Control group; Conventional on-scene care of acute coronary syndromes by a physician. No telemedicine system was available during this control period.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Adverse events	respiratory / circulatory insufficiency, allergic reaction, cardiac arrest	prehospital phase (0.5-2 hours)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Correct use of Aspirin	Correct use of Aspirin based on current guidelines	prehospital phase (0.5-2 hours)
Correct use of unfractionated Heparin (UFH)	Correct use of UFH based on current guidelines	prehospital phase (0.5-2 hours)
Correct use of Morphine	Correct use of Morphine based on current guidelines	prehospital phase (0.5-2 hours)
Use of 12-lead-ECG	Use of 12-lead-ECG after first medical contact	prehospital phase (0.5-2 hours)
Correct transport destination	hospital with cath lab in ST-segment elevation myocardial infarction or high-risk Non-STEMI-ACS	prehospital phase (0.5-2 hours)
Correct use of oxygen	Correct use of Morphine based on current guidelines	prehospital phase (0.5-2 hours)
Correct use of Glyceroltrinitrate	Correct use of Glyceroltrinitrate based on current guidelines	prehospital phase (0.5-2 hours)

Collaborators and Investigators

• Sponsor: RWTH Aachen University

Study record dates

Study Major Dates

• Study Start (Actual): January 1, 2014
• Primary Completion (Actual): July 31, 2015
• Study Completion (Actual): July 31, 2015

Study Registration Dates

• First Submitted: April 24, 2017
• First Submitted That Met QC Criteria: April 24, 2017
• First Posted (Actual): April 28, 2017

Study Record Updates

• Last Update Posted (Actual): April 28, 2017
• Last Update Submitted That Met QC Criteria: April 24, 2017
• Last Verified: April 1, 2017

More Information

Terms related to this study

• Keywords: Telemedicine; ST-segment elevation myocardial infarction; Non-STEMI Acute Coronary Syndrome
• Additional Relevant MeSH Terms: Pathologic Processes; Myocardial Ischemia; Heart Diseases; Cardiovascular Diseases; Vascular Diseases; Disease; Syndrome; Acute Coronary Syndrome
• Other Study ID Numbers: TEMS-ACS

Plan for Individual participant data (IPD)

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

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No