Simulation RCT of Telemedical Support for Paramedics
| Status: | Enrolling by invitation |
|---|---|
| Conditions: | Asthma, Cardiology, Pulmonary |
| Therapuetic Areas: | Cardiology / Vascular Diseases, Pulmonary / Respiratory Diseases |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 2/17/2019 |
| Start Date: | December 18, 2018 |
| End Date: | September 2019 |
Randomized Control Trial of Telemedical Support for Paramedics in Simulated Pre-hospital Pediatric Emergencies
This study evaluates the impact of video communication via telemedicine on the quality of
emergency care provided to children by paramedic teams supported by a remote physician in a
simulated out-of-hospital setting. Half of the paramedic teams will use a video telemedicine
platform for communication with a physician, while the other half will use an audio-only
platform.
emergency care provided to children by paramedic teams supported by a remote physician in a
simulated out-of-hospital setting. Half of the paramedic teams will use a video telemedicine
platform for communication with a physician, while the other half will use an audio-only
platform.
In the United States, the current standard of pre-hospital (out-of-hospital) emergency care
for children with life-threatening illnesses in the community includes remote physician
medical direction for paramedics providing life-saving therapies while transporting the child
to the hospital. Most pre-hospital emergency medical service (EMS) agencies use radios
systems for audio communication between paramedics and physicians. This communication
strategy is inherently limited as the remote physician cannot visualize the patient for
accurate assessment and to direct treatment.
The purpose of this pilot study is to evaluate whether use of a 2-way audiovisual connection
with a pediatric emergency medicine expert (intervention = "telemedical support") will
improve the quality of care provided by paramedics to infant simulator mannequins with
life-threatening illnesses. Paramedics receiving real-time telemedical support by a pediatric
expert may provide better care due to decreased cognitive burden, critical action checking,
protocol verification, and error correction.
Because real pediatric life-threatening illnesses are rare, high-stakes events and involve a
vulnerable population (children), this pilot randomized control trial will provide early data
on the efficacy of this intervention in simulated cases of pediatric medical emergencies. The
primary outcome is "paramedic resuscitation performance" measured by a checklist of
observable critical actions by independent reviewers during live observation and video
review. The results of this study will provide important pilot data to estimate the clinical
effect of this intervention and the sample size needed for a future definitive trial with
children, a vulnerable population.
for children with life-threatening illnesses in the community includes remote physician
medical direction for paramedics providing life-saving therapies while transporting the child
to the hospital. Most pre-hospital emergency medical service (EMS) agencies use radios
systems for audio communication between paramedics and physicians. This communication
strategy is inherently limited as the remote physician cannot visualize the patient for
accurate assessment and to direct treatment.
The purpose of this pilot study is to evaluate whether use of a 2-way audiovisual connection
with a pediatric emergency medicine expert (intervention = "telemedical support") will
improve the quality of care provided by paramedics to infant simulator mannequins with
life-threatening illnesses. Paramedics receiving real-time telemedical support by a pediatric
expert may provide better care due to decreased cognitive burden, critical action checking,
protocol verification, and error correction.
Because real pediatric life-threatening illnesses are rare, high-stakes events and involve a
vulnerable population (children), this pilot randomized control trial will provide early data
on the efficacy of this intervention in simulated cases of pediatric medical emergencies. The
primary outcome is "paramedic resuscitation performance" measured by a checklist of
observable critical actions by independent reviewers during live observation and video
review. The results of this study will provide important pilot data to estimate the clinical
effect of this intervention and the sample size needed for a future definitive trial with
children, a vulnerable population.
Inclusion Criteria:
- Certified paramedics from Boston EMS, the largest urban municipal advanced life
support agency for the city of Boston
- BUMC attending physicians and clinical fellows with expertise in pediatric emergency
medicine and pediatric resuscitation
Exclusion Criteria:
-Prehospital providers without paramedic level certification (e.g. BLS certification only)
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