1. Guideline adherence in acute coronary syndromes between telemedically supported paramedics and conventional on-scene physician care: A longitudinal pre-post intervention cohort study.
- Author
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Bergrath S, Müller M, Rossaint R, Beckers SK, Uschner D, and Brokmann JC
- Subjects
- Acute Coronary Syndrome, Adult, Aged, Aged, 80 and over, Allied Health Personnel statistics & numerical data, Electrocardiography methods, Electrocardiography statistics & numerical data, Female, Germany, Guideline Adherence, Humans, Logistic Models, Male, Middle Aged, Physicians, Telemedicine methods, Allied Health Personnel standards, Emergency Medical Services methods, Telemedicine standards
- Abstract
Health informatics applications reduce time intervals in acute coronary syndromes, but their impact on guideline adherence is unknown. This pre-post intervention study compared guideline adherence between telemedically supported (n = 101, April 2014-July 2015) and conventional on-scene care (n = 120, January 2014-March 2014) in acute coronary syndrome. A multivariate logistic regression was performed for dependent variables: adverse events 0 versus 0, p = NA; electrocardiogram 101 versus 120, p = NA; acetylic salicylic acid 91 versus 102, p = 0.21; heparin 92 versus 112, p = 0.99; morphine 96 versus 107, p = 0.33; oxygen 83 versus 102, p = 0.92; glyceroltrinitrate 55 versus 90, p = 0.038; correct destination: 100 versus 119, p = 1.0. The time from ambulance arrival to hospital arrival was prolonged with telemedicine: 48.7 ± 11 min versus 35.5 ± 8.1 min, p < 0.001. Guideline adherence showed no differences except for glyceroltrinitrate. Prolonged time requirements are critical, though explainable. However, this approach enables a timely and high-quality backup strategy if only paramedics are on-scene.
- Published
- 2019
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