Tarso Augusto Duenhas Accorsi, João Carlos Barbosa, Ricardo Galesso Cardoso, José Leão de Souza Junior, Karine De Amicis, Renata Albaladejo Morbeck, José Paulo Ladeira, Eduardo Cordioli, Carlos Henrique Sartorato Pedrotti
{"title":"通过院前检查救护车调度远程会诊减少急救小组现场停留时间的可行性和假设探索的试点研究。","authors":"Tarso Augusto Duenhas Accorsi, João Carlos Barbosa, Ricardo Galesso Cardoso, José Leão de Souza Junior, Karine De Amicis, Renata Albaladejo Morbeck, José Paulo Ladeira, Eduardo Cordioli, Carlos Henrique Sartorato Pedrotti","doi":"10.31744/einstein_journal/2025AO1469","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>This pilot study showed that teleconsultation during ambulance dispatch considerably reduced the emergency team's on-scene evaluation time, underscoring the potential of telemedicine in prehospital care. ■ Teleconsultation reduced on-scene time from 36.8 to 20.6 min (p=0.019). ■ Video-based prearrival anamnesis improved team efficiency. ■ Interventions and clinical profiles were similar across the groups. ■ Study supports broader telemedicine adoption in emergency care.</p><p><strong>Objective: </strong>Ambulance transport time is an important metric in prehospital care. Limited studies have explored strategies to decrease on-scene time. We examined the effect of collecting telemedicine-based medical data during ambulance dispatch on the on-scene evaluation time of the prehospital team.</p><p><strong>Methods: </strong>This randomized, single-center, open-label study included individuals aged >18 years who independently sought hospital emergency services and requested on-site emergency care. Individuals with primary trauma emergencies occurring outside the home, cardiac arrest cases, and situations in which video communication was unfeasible were excluded.</p><p><strong>Results: </strong>Twenty patients were randomized to receive telemedicine assessment during ambulance dispatch or standard care with physician phone support. Both groups were comparable in age (53.2 ± 26.1 versus 63.4 ± 24.2 years, p=0.380), sex (50% versus 70% female, p=0.360), initial vital signs, and medical history. The main reasons for patients calls were falls from standing height (30%), followed by cardiovascular symptoms (20%), and acute neurological events (15%). Teleconsultation via a mobile application was successfully conducted in all cases. Furthermore, in situ interventions, including venous access, oxygen therapy, orthopedic immobilization, hypotension stabilization, and symptomatic treatment, were similar between the groups. The Telemedicine Group demonstrated a significantly shorter on-scene evaluation time (20.45 ± 6 min) than the Standard Group (36.80 ± 20.4 min, p = 0.019).</p><p><strong>Conclusion: </strong>Conducting checklist-based anamnesis teleconsultation during ambulance dispatch considerably decreased the on-scene evaluation time of the emergency team. Further research with larger cohorts and different settings is required to better examine telemedicine's potential in this context.</p>","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":"23 ","pages":"eAO1469"},"PeriodicalIF":0.9000,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12094677/pdf/","citationCount":"0","resultStr":"{\"title\":\"A pilot study on feasibility and hypothesis exploration: reducing on-scene length of stay of the emergency teams via ambulance dispatch teleconsultation for prehospital examination.\",\"authors\":\"Tarso Augusto Duenhas Accorsi, João Carlos Barbosa, Ricardo Galesso Cardoso, José Leão de Souza Junior, Karine De Amicis, Renata Albaladejo Morbeck, José Paulo Ladeira, Eduardo Cordioli, Carlos Henrique Sartorato Pedrotti\",\"doi\":\"10.31744/einstein_journal/2025AO1469\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>This pilot study showed that teleconsultation during ambulance dispatch considerably reduced the emergency team's on-scene evaluation time, underscoring the potential of telemedicine in prehospital care. ■ Teleconsultation reduced on-scene time from 36.8 to 20.6 min (p=0.019). ■ Video-based prearrival anamnesis improved team efficiency. ■ Interventions and clinical profiles were similar across the groups. ■ Study supports broader telemedicine adoption in emergency care.</p><p><strong>Objective: </strong>Ambulance transport time is an important metric in prehospital care. Limited studies have explored strategies to decrease on-scene time. We examined the effect of collecting telemedicine-based medical data during ambulance dispatch on the on-scene evaluation time of the prehospital team.</p><p><strong>Methods: </strong>This randomized, single-center, open-label study included individuals aged >18 years who independently sought hospital emergency services and requested on-site emergency care. Individuals with primary trauma emergencies occurring outside the home, cardiac arrest cases, and situations in which video communication was unfeasible were excluded.</p><p><strong>Results: </strong>Twenty patients were randomized to receive telemedicine assessment during ambulance dispatch or standard care with physician phone support. Both groups were comparable in age (53.2 ± 26.1 versus 63.4 ± 24.2 years, p=0.380), sex (50% versus 70% female, p=0.360), initial vital signs, and medical history. The main reasons for patients calls were falls from standing height (30%), followed by cardiovascular symptoms (20%), and acute neurological events (15%). Teleconsultation via a mobile application was successfully conducted in all cases. Furthermore, in situ interventions, including venous access, oxygen therapy, orthopedic immobilization, hypotension stabilization, and symptomatic treatment, were similar between the groups. The Telemedicine Group demonstrated a significantly shorter on-scene evaluation time (20.45 ± 6 min) than the Standard Group (36.80 ± 20.4 min, p = 0.019).</p><p><strong>Conclusion: </strong>Conducting checklist-based anamnesis teleconsultation during ambulance dispatch considerably decreased the on-scene evaluation time of the emergency team. Further research with larger cohorts and different settings is required to better examine telemedicine's potential in this context.</p>\",\"PeriodicalId\":47359,\"journal\":{\"name\":\"Einstein-Sao Paulo\",\"volume\":\"23 \",\"pages\":\"eAO1469\"},\"PeriodicalIF\":0.9000,\"publicationDate\":\"2025-05-12\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12094677/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Einstein-Sao Paulo\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.31744/einstein_journal/2025AO1469\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Einstein-Sao Paulo","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.31744/einstein_journal/2025AO1469","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0
摘要
背景:这项初步研究表明,救护车调度期间的远程会诊大大减少了急救小组的现场评估时间,强调了远程医疗在院前护理中的潜力。远程会诊将现场时间从36.8分钟减少到20.6分钟(p=0.019)。■基于视频的到达前记忆提高了团队效率。■各组的干预措施和临床概况相似。■研究支持在急诊护理中广泛采用远程医疗。目的:救护车运送时间是院前护理的重要指标。有限的研究探索了减少现场时间的策略。我们检验了在救护车调度过程中收集基于远程医疗的医疗数据对院前团队现场评估时间的影响。方法:这项随机、单中心、开放标签的研究纳入了年龄在bb0 ~ 18岁、独立寻求医院急救服务并要求现场急救的个体。排除了发生在家庭以外的原发性创伤紧急情况、心脏骤停病例和视频通信不可行的情况。结果:20例患者随机接受远程医疗评估在救护车调度或标准护理与医生电话支持。两组在年龄(53.2±26.1岁对63.4±24.2岁,p=0.380)、性别(50%对70%为女性,p=0.360)、初始生命体征和病史方面具有可比性。患者呼叫的主要原因是站立高度坠落(30%),其次是心血管症状(20%)和急性神经系统事件(15%)。所有病例均成功通过移动应用程序进行远程会诊。此外,原位干预,包括静脉通路、氧疗、骨科固定、低血压稳定和对症治疗,在两组之间是相似的。远程医疗组现场评估时间(20.45±6 min)明显短于标准组(36.80±20.4 min, p = 0.019)。结论:在救护车调度过程中开展基于核对表的远程问诊,大大减少了急救小组的现场评估时间。需要对更大的队列和不同的环境进行进一步的研究,以便更好地检查远程医疗在这方面的潜力。
A pilot study on feasibility and hypothesis exploration: reducing on-scene length of stay of the emergency teams via ambulance dispatch teleconsultation for prehospital examination.
Background: This pilot study showed that teleconsultation during ambulance dispatch considerably reduced the emergency team's on-scene evaluation time, underscoring the potential of telemedicine in prehospital care. ■ Teleconsultation reduced on-scene time from 36.8 to 20.6 min (p=0.019). ■ Video-based prearrival anamnesis improved team efficiency. ■ Interventions and clinical profiles were similar across the groups. ■ Study supports broader telemedicine adoption in emergency care.
Objective: Ambulance transport time is an important metric in prehospital care. Limited studies have explored strategies to decrease on-scene time. We examined the effect of collecting telemedicine-based medical data during ambulance dispatch on the on-scene evaluation time of the prehospital team.
Methods: This randomized, single-center, open-label study included individuals aged >18 years who independently sought hospital emergency services and requested on-site emergency care. Individuals with primary trauma emergencies occurring outside the home, cardiac arrest cases, and situations in which video communication was unfeasible were excluded.
Results: Twenty patients were randomized to receive telemedicine assessment during ambulance dispatch or standard care with physician phone support. Both groups were comparable in age (53.2 ± 26.1 versus 63.4 ± 24.2 years, p=0.380), sex (50% versus 70% female, p=0.360), initial vital signs, and medical history. The main reasons for patients calls were falls from standing height (30%), followed by cardiovascular symptoms (20%), and acute neurological events (15%). Teleconsultation via a mobile application was successfully conducted in all cases. Furthermore, in situ interventions, including venous access, oxygen therapy, orthopedic immobilization, hypotension stabilization, and symptomatic treatment, were similar between the groups. The Telemedicine Group demonstrated a significantly shorter on-scene evaluation time (20.45 ± 6 min) than the Standard Group (36.80 ± 20.4 min, p = 0.019).
Conclusion: Conducting checklist-based anamnesis teleconsultation during ambulance dispatch considerably decreased the on-scene evaluation time of the emergency team. Further research with larger cohorts and different settings is required to better examine telemedicine's potential in this context.