Video-instructed First Aid in Emergency Medical Call Centers

October 31, 2023 updated by: Magnus Hjortdahl, Oslo Metropolitan University

Video Streaming in Norwegian Emergency Medical Call Centers as a Supplement to Telephone-instructed Bystander First Aid for Injured Patients

Video streaming as an additional tool to telephone was introduced in some Norwegian emergency medical call centers during the spring of 2020. This allows the dispatchers to communicate with the caller through video streaming during emergency calls. Some studies are conducted on this use of video streaming, but further research is needed.

In this study, the investigators have chosen to focus on potential effect from video streaming on bystander first aid for injured patients. The investigators have knowledge from preliminary results that dispatchers often find video streaming useful in emergency calls regarding injuries.

This study will investigate whether the use of video streaming might have an effect on the recognition rate by dispatchers on the need for bystander first aid for injured patients. In addition, the investigators will investigate whether video-instructions from dispatcher can improve bystander first aid quality.

The investigators will be using data collected by ambulance personnel including patients with injuries, as well as data from EMCC journals and audio logs.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Background:

Emergency Medical Communication Centres (EMCCs) in Norway receive more than 400 000 emergency calls every year, resulting in more than 250 000 ambulance dispatches. Emergency calls are answered by nurses or paramedics with special training, who by audio assesses the situation and decides on a response. Video streaming as a supplement to telephone in EMCC was introduced during springtime 2020 in Norway, and is independent of this study. The intended effect was to improve shared situational awareness between caller and operator, and thus improve the triage process. The video solution is live-only, and caller must give consent. Limited scientific evidence for such use exists, and even if video calls seems commonplace in society, the effects and acceptance in EMCCs has mainly been studied in simulated settings. Preliminary results from the early launch of video streaming showed that injured patients was one of the conditions where the dispatchers seemed to find video streaming useful. Previous studies by Bakke et.al investigating bystander first aid for injured patients, showed a potential for dispatchers in EMCCs to recognize more injured patients with the need for bystander first aid.

Aim:

This study focuses on the effect of video streaming in EMCCs on bystander first aid. The investigators aim to investigate whether dispatchers identifies the need for relevant first aid measures more frequently when using video streaming. The study will be conducted in several health trusts in Norway. In health trusts where video streaming not yet has been implemented in the EMCC, the investigators will collect data from period before video streaming is implemented, and after video streaming is implemented. From some health trusts in the study, video streaming already been implemented, and data collection will hence only be conducted for an after-period.

Methods and population size:

The number needed to treat is based on the studies by Bakke et al, as well it is based on one of our outcome goals: an aim for improvement of correctly identification of need for first aid by EMCC operator from 35% to 50%. Bakke et al included 355 cases during 18 months, which was done in a study area with approximately 270.500 inhabitants. For achievement of power of 0,80 and p-value <0,05 we need each study group to be 169, with the aimed improvement of 15%. Adding an estimate of missing cases of 10%, our study sample size for each group for this outcome measure is estimated to approximately 200 cases. For the outcome goal on quality improvement on first aid, which we aim the effect to be a raise in 20%, there is no aggregated outcome from previous studies to base an improvement on. The investigators therefore base our study sample size on number of cases included in Bakke's study. For this study to reach inclusion of 355 cases and with a study area with 1.150.000 inhabitants, the investigators need four months for each period. In Bakke's study, inclusion criteria were based on ICD-10 from hospital admissions. The investigators are therefore confident that the study will reach a minimum of 355 cases including patients not admitted to hospital as well. Based on these calculations on study sample sizes, the investigators estimate each of the before- and after periods to last 4 months, where cases before video implementation will be compared to calls after, separated by a wash-in period of 1-2 months.

Data collection and analyzes:

Patients will be included by ambulance personnel after the study's inclusion criteria. Ambulance personnel on scene will collect data through an internet-based questionnaire on need for first aid measures and quality of bystander first aid. In addition, data will be collected from EMCC journals and audio logs. This data will contain information on dispatchers recognition of first aid measures, as well as information on prehospital resources and time data. The investigators will also apply for data from the National Trauma Registry. Ambulance personnel participating in the data collection will complete an educational course about the questionnaire. The questionnaire used will be validated in a separate study. Analyzes of primary and secondary outcomes will be executed according to the ITT-principle. Uni- and multivariate regression analysis will be conducted.

Ethics:

The study is assessed by the Regional ethics committee in Norway as outside area of jurisdiction. It is approved by the Norwegian Center for Research Data and the Norwegian Health Directorate.

Study Type

Observational

Enrollment (Actual)

174

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Norway
      • Oslo, Norway, 0166
        • University of OsloMet

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Child
  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Sampling Method

Non-Probability Sample

Study Population

Patients with injuries who meet the inclusion criteria in the health trusts cooperating as study areas.

Description

Inclusion Criteria:

  • Patient with an injury,
  • One or more bystanders at scene,
  • One or more of the following first aid measures have been attempted or should have been attempted: Open airway, bleeding control, recovery position, hypothermia prevention.

Exclusion Criteria:

  • The caller is at a different location than the patient
  • Patients who are alone on scene and contacted the EMCC themselves

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Observational Models: Other
  • Time Perspectives: Prospective

Cohorts and Interventions

Group / Cohort
Intervention / Treatment
Before
Injured patients included in the study from health trusts where video streaming not yet has been implemented in the EMCC
After
Injured patients included in the study from health trusts where video streaming has been implemented in the EMCC
Other: Video streaming
Video streaming as a supplement to telephone during emergency calls for dispatchers at EMCCs

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Dispatchers' recognition of relevant first aid measures
Time Frame: Through study completion, an average of 1,5 years
Number of patients where dispatchers in the EMCCs recognizes relevant first aid measures
Through study completion, an average of 1,5 years

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
First aid measures performed by bystander
Time Frame: Through study completion, an average of 1,5 years
Number of patients with first aid measures performed by bystander before the arrival of the first ambulance unit
Through study completion, an average of 1,5 years
Bystander first aid quality
Time Frame: Through study completion, an average of 1,5 years
Number of patients with first aid measures of high quality performed by bystander
Through study completion, an average of 1,5 years

Other Outcome Measures

Outcome Measure
Measure Description
Time Frame
Time delay until activation of first ambulance
Time Frame: Through study completion, an average of 1,5 years
No increase in time from the emergency call is received until activation of first ambulance unit
Through study completion, an average of 1,5 years
Time delay until need for first aid is recognized by dispatcher
Time Frame: Through study completion, an average of 1,5 years
No increase in time from the emergency call is received until need for first aid is recognized by the dispatcher
Through study completion, an average of 1,5 years
30-days mortality for patients included
Time Frame: Through study completion, an average of 1,5 years
No increase in 30-days mortality for patients where video streaming was used
Through study completion, an average of 1,5 years

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Oslo Metropolitan University

Collaborators

Vestre Viken Hospital Trust
Oslo University Hospital
University Hospital of North Norway
Ostfold Hospital Trust
Helse Stavanger HF
Laerdal Foundation

Investigators

  • Principal Investigator: Magnus Hjortdahl, PhD, OsloMet

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

November 8, 2021

Primary Completion (Actual)

February 28, 2023

Study Completion (Actual)

June 30, 2023

Study Registration Dates

First Submitted

October 25, 2021

First Submitted That Met QC Criteria

November 5, 2021

First Posted (Actual)

November 16, 2021

Study Record Updates

Last Update Posted (Actual)

November 1, 2023

Last Update Submitted That Met QC Criteria

October 31, 2023

Last Verified

October 1, 2023

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 247264

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

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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