Audiovisual Consults by Paramedics to Reduce Hospital Transport After Low-Urgency Calls: Randomized Controlled Trial

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00216208%3A11120%2F20%3A43920614" target="_blank" >RIV/00216208:11120/20:43920614 - isvavai.cz</a>

Alternative codes found

RIV/00216208:11140/20:10415708 RIV/00064173:_____/20:N0000172

Result on the web

<a href="https://doi.org/10.1017/S1049023X2000117X" target="_blank" >https://doi.org/10.1017/S1049023X2000117X</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1017/S1049023X2000117X" target="_blank" >10.1017/S1049023X2000117X</a>

Result language

angličtina

Original language name

Audiovisual Consults by Paramedics to Reduce Hospital Transport After Low-Urgency Calls: Randomized Controlled Trial

Original language description

INTRODUCTION: The effect and subjective perception of audiovisual consults (AVCs) by paramedics with a distant physician in prehospital emergency care (PHEC) remain unexplained, especially in low-urgency calls. OBJECTIVES: The primary objective of the study was to evaluate the effect of AVCs by paramedics with a base physician on the rate of patients treated on site without the need of hospital transfer. The co-primary safety outcome was the frequency of repeated ambulance trips within 48 hours to the same patient. Secondary objective was the qualitative analysis of perception of the AVCs. METHODS: During a six-week period, the dispatching center of Karlovy Vary Emergency Medical Service (EMS) randomized low-urgency events from a rural area (n = 791) to receive either a mandatory phone-call consult (PHONE), AVC (VIDEO), or performed by the paramedic crew in a routine manner, when phone-call consultation is for paramedic crew optional (CONTROL). Secondarily, the qualitative analysis of subjective perception of AVCs compared to consultation over the phone by the paramedic and consulting physician was performed. RESULTS: Per-protocol analysis (PPA) was performed (CONTROL, n = 258; PHONE, n = 193; and VIDEO, n = 192) in addition to the intention-to-treat (ITT) analysis. Patients (PPA) in both mandatory consulted groups were twice as likely to be treated and left on site compared to the CONTROL (PHONE: OR = 2.07; 95% CI, 1.19 to 3.58; P = 0.01 or VIDEO: OR = 2.01; 95% CI, 1.15 to 3.49; P = .01). Repeated trips to patients treated and left on site in 48 hours occurred in three (8.6%) of 35 cases in the PHONE group and in eight (23.5%) of 34 cases in the VIDEO group. CONCLUSIONS: The AVCs of the emergency physician by paramedics was not superior to the mandatory conventional phone call in increasing the proportion of patients treated and left at home after a low-urgency call. The AVC improved the subjective feelings of safety by physicians, but not the satisfaction of patients or paramedics, and may lead to an increased need of repeated trips.

Czech name

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Czech description

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Type

J_imp - Article in a specialist periodical, which is included in the Web of Science database

CEP classification

—

OECD FORD branch

30221 - Critical care medicine and Emergency medicine

Project

—

Continuities

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Publication year

2020

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

Prehospital and Disaster Medicine

ISSN

1049-023X

e-ISSN

—

Volume of the periodical

35

Issue of the periodical within the volume

6

Country of publishing house

US - UNITED STATES

Number of pages

7

Pages from-to

656-662

UT code for WoS article

000591875900011

EID of the result in the Scopus database

2-s2.0-85092244745