Accorsi Tarso Augusto Duenhas, Barbosa João Carlos, Cardoso Ricardo Galesso, Souza Junior José Leão de, Amicis Karine De, Morbeck Renata Albaladejo, Ladeira José Paulo, Cordioli Eduardo, Pedrotti Carlos Henrique Sartorato
Telemedicine Department, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
Emergency Department, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
Einstein (Sao Paulo). 2025 May 12;23:eAO1469. doi: 10.31744/einstein_journal/2025AO1469. eCollection 2025.
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.
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.
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.
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).
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.
这项试点研究表明，在救护车调度期间进行远程会诊可显著缩短急救团队的现场评估时间，凸显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分钟缩短至20.6分钟（p = 0.019）。
基于视频的院前问诊提高了团队效率。
各小组的干预措施和临床特征相似。
研究支持在急救护理中更广泛地采用远程医疗。
救护车运送时间是院前护理的一项重要指标。有限的研究探索了减少现场时间的策略。我们研究了在救护车调度期间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。
这项随机、单中心、开放标签研究纳入了年龄大于18岁、独立寻求医院急诊服务并要求现场急救护理的个体。排除在家外发生原发性创伤紧急情况的个体、心脏骤停病例以及无法进行视频通信的情况。
20名患者被随机分配在救护车调度期间接受远程医疗评估或接受有医生电话支持的标准护理。两组在年龄（53.2±26.1岁对63.4±24.2岁，p = 0.380）、性别（女性分别为50%对70%，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从站立高度跌落（30%），其次是心血管症状（20%）和急性神经事件（15%）。所有病例均成功通过移动应用程序进行了远程会诊。此外，两组之间的现场干预措施，包括静脉通路、氧疗、骨科固定、低血压稳定和对症治疗相似。远程医疗组的现场评估时间（20.45±6分钟）明显短于标准组（36.80±20.4分钟，p = 0.019）。
在救护车调度期间进行基于清单的问诊远程会诊可显著缩短急救团队的现场评估时间。需要在更大的队列和不同的环境中进行进一步研究，以更好地检验远程医疗在此背景下的潜力。
