Introduction of Telemedicine in a Prehospital Emergency Care Setting: A Pilot Study
Table 5
Details of prehospital emergency physician (PHP) actions/decisions.
PHP missions
Tele-PHP (49)
On-site-PHP (403)
Total (452)
PHP actions/decisions°
17 (34%)
267 (66%)
284 (63%)
Therapy (; percentage)°
6 (12%)
122 (30%)
128 (28%)
(i) IV hydration
0
7
7
(ii) Toxic antagonist
0
1
1
(iii) Painkillers
0
14
14
(iv) Antiarrhythmic
0
4
4
(v) Antihypertensive
0
4
4
(vi) Antiplatelet anticoagulation
1
11
12
(vii) Sedation
0
20
20
(viii) Bronchodilator
1
8
9
(ix) Vasopressor
0
19
19
(x) Glucose
0
4
4
(xi) Other treatment
4
17
21
Medical decision°
15 (30%)
122 (30%)
137 (30%)
(i) ECG analysis
2
22
24
(ii) Diagnosis
13
90
103
(iii) Patient orientation
0
10
10
Technical gesture°
1 (2%)
66 (16%)
67 (15%)
(i) Ventilation
0
10
10
(ii) Intubation
0
21
21
(iii) Defibrillation
0
2
2
(iv) Pneumothorax exsufflation
0
1
1
(v) External pacing
0
2
2
(vi) Cardioversion
0
2
2
(vii) Thoracotomy
0
0
0
(viii) Leadership
1
29
30
Legal aspect°
0 (0%)
72 (18%)
72 (16%)
(i) Death certificate
0
46
46
(ii) Leave the patient on site
0
11
11
(iii) Privation of liberty
0
15
15
(iv) Decision not to reanimate a patient
0
23
23
49 tele-PHP missions performed including five tele-PHP missions dispatched after first evaluation at the paramedics’ request. Cancelled missions and missions with connection issues (6) are excluded. 403 on-site PHP mission performed including 44 on-site PHP missions dispatched after first evaluation at the paramedics’ request and the three tele-PHP switched to on-site PHP mission. Cancelled missions are excluded. °Missions can have more than one added value such as do not attempt to resuscitate or termination of resuscitation and establishing a death certificate. ECG: electrocardiogram; IV: intravenous.
