Real-time video communication between ambulance paramedic and scene - a simulation-based study

Introduction Telemedicine has been widely used in various medical settings including in Emergency Medical Services (EMS). The goal of this study was to assess the possible roles of real-time video communication between paramedics and bystanders at scenes of emergency, in the analysis and treatment of patients. Methods 44 experienced paramedics participated in a simulation. Participants communicated with the experimenter presenting video clips showing patients that simulated three emergency scenarios: trauma, an unresponsive patient with cardiac arrest, and an opiate overdose. The simulation sessions were conducted through Zoom (TM), recorded, and then analyzed to document participants' questions, requests, instructions, and their timings during each scenario. Results The trauma scenario was assessed most promptly, with instructions to handle the bleeding provided by all paramedics. In the unresponsive patient with cardiac arrest scenario, most of the participants achieved a correct initial diagnosis, and in the opiate overdose scenario over half of paramedics sought visual clinical clues for the differential diagnoses of loss of consciousness and their causes. Additional results show the type of assessment, treatment and diagnosis participants provided in each scenario, and their confidence about situation. Conclusions The findings show that direct video communication between paramedic and scene may facilitate correct diagnosis, provision of instructions for treatment, and early preparation of medications or equipment. These may decrease time to correct diagnosis and lifesaving treatment and impact patient morbidity and mortality. Moreover, the findings highlight the difference between incidents with higher visual clarity, such as trauma, and conditions that require an extended diagnosis to reveal, such as unresponsive patients. This may also increase the paramedics' mental preparedness for what is expected at the scene.

Automated summary

The study aimed to assess the potential roles of real-time video communication between paramedics and bystanders in the analysis and treatment of patients at emergency scenes. The findings showed that video communication facilitated correct diagnosis, provision of treatment instructions, and early preparation for medication or equipment, leading to reduced time for correct diagnosis and lifesaving treatment and affecting patient morbidity and mortality. Additionally, the study highlighted the difference between incidents with higher visual clarity, such as trauma, and conditions requiring extended diagnosis, such as unresponsive patients, which could increase paramedics' mental preparedness for the scene.