Jobé Christophe, Carron Pierre-Nicolas, Métrailler Pierre, Bellagamba Jean-Marc, Briguet Alexandre, Zurcher Line, Dami Fabrice
Emergency Department, Lausanne University Hospital (CHUV), Lausanne, Switzerland.
University of Lausanne, Lausanne, Switzerland.
Int J Telemed Appl. 2023 Mar 23;2023:1171401. doi: 10.1155/2023/1171401. eCollection 2023.
Advances in information and communication technology have led to telemedicine applications that could support paramedics in the prehospital field. In an effort to optimise the available resources like prehospital emergency physicians (PHP), the State Health Services of a Swiss state decided to launch a pilot study on the feasibility of using telemedicine in the prehospital emergency setting.
The primary objective was to measure the number of missions completed without technical problems with remote PHP support through telemedicine (tele-PHP). The secondary objectives were to evaluate the safety of this protocol and to describe the actions and decisions that clinicians can make by using tele-PHP.
This was a prospective observational pilot study on all missions involving the dispatch of ground PHP or tele-PHP. The severity score, dispatch criteria, actions, and decisions made by ground PHP and tele-PHP were collected.
PHP were dispatched simultaneously with an ambulance on 478 occasions, including 68 (14%) situations that started directly with tele-PHP. Among those situations, three had to be transformed into on-site PHP missions after the on-site evaluation by paramedics. Fifteen missions were cancelled by paramedics once they were on site, and six missions encountered a connection issue. Forty-four PHP missions that were dispatched simultaneously with paramedics were completed by tele-PHP only without any connection problems. Paramedics and PHP estimated that actions or decisions were provided by PHP in 66% of the on-site PHP missions and 34% of the tele-PHP missions.
This is the first experience of tele-PHP regarding PHP dispatch in Switzerland. Despite the small number of missions carried out, tele-PHP could be used for well-selected situations to reduce the need for a PHP on site.
信息和通信技术的进步催生了远程医疗应用，可在院前领域为护理人员提供支持。为了优化诸如院前急救医生（PHP）等可用资源，瑞士一个州的州卫生服务部门决定开展一项关于在院前急救环境中使用远程医疗可行性的试点研究。
主要目的是测量在远程PHP支持（远程PHP）下无技术问题完成的任务数量。次要目的是评估该方案的安全性，并描述临床医生使用远程PHP时可采取的行动和做出的决策。
这是一项针对所有涉及地面PHP或远程PHP调度任务的前瞻性观察性试点研究。收集了地面PHP和远程PHP的严重程度评分、调度标准、行动和决策。
PHP与救护车同时调度了478次，其中包括68次（14%）直接从远程PHP开始的情况。在这些情况中，有三次在护理人员进行现场评估后不得不转变为现场PHP任务。15次任务在护理人员到达现场后被取消，6次任务遇到连接问题。44次与护理人员同时调度的PHP任务仅通过远程PHP完成，没有任何连接问题。护理人员和PHP估计，在66%的现场PHP任务和34%的远程PHP任务中，PHP提供了行动或决策。
这是瑞士关于PHP调度的远程PHP的首次经验。尽管开展的任务数量较少，但远程PHP可用于精心挑选的情况，以减少现场PHP的需求。
