Live video from bystanders’ smartphones to medical dispatchers in real emergencies

Abstract

Background Medical dispatchers have limited information to assess the appropriate emergency response when citizens call the emergency number. We explored whether live video from bystanders’ smartphones changed emergency response and was beneficial for the dispatcher and caller. Methods From June 2019 to February 2020, all medical dispatchers could add live video to the emergency calls at Copenhagen Emergency Medical Services, Denmark. Live video was established with a text message link sent to the caller’s smartphone using GoodSAM®. To avoid delayed emergency response if the video transmission failed, the medical dispatcher had to determine the emergency response before adding live video to the call. We conducted a cohort study with a historical reference group. Emergency response and cause of the call were registered within the dispatch system. After each video, the dispatcher and caller were given a questionnaire about their experience. Results Adding live video succeeded in 838 emergencies (82.2% of attempted video transmissions) and follow-up was possible in 700 emergency calls. The dispatchers’ assessment of the patients’ condition changed in 51.1% of the calls (condition more critical in 12.9% and less critical in 38.2%), resulting in changed emergency response in 27.5% of the cases after receiving the video (OR 1.58, 95% CI: 1.30–1.91) compared to calls without video. Video was added more frequently in cases with sick children or unconscious patients compared with normal emergency calls. The dispatcher recognized other or different disease/trauma in 9.9% and found that patient care, such as the quality of cardiopulmonary resuscitation, obstructed airway or position of the patient, improved in 28.4% of the emergencies. Only 111 callers returned the questionnaire, 97.3% of whom felt that live video should be implemented. Conclusions It is technically feasible to add live video to emergency calls. The medical dispatcher’s perception of the patient changed in about half of cases. The odds for changing emergency response were 58% higher when video was added to the call. However, use of live video is challenging with the existing dispatch protocols, and further implementation science is necessary.

Live video from bystanders’ smartphones to improve cardiopulmonary resuscitation

“…Further details about the implementation can be found in another study. 14 The audio and video recording were combined for the analysis. All suspected OCHA cases where CPR continued or started after the live video transmission had begun were included.…”

Telemedicine for emergency patients in pre-hospital care: A scoping review

“…23 After conducting patients' medical condition and history assessment, physical examination with vital sign monitoring, and other diagnostic procedures, EMS paramedics can either tele-transmit the result to a physician and get notified with text or audio for further advice for diagnosis or therapy 24 , or use audio and video features where they can connect virtually to physicians. [16][17][18][19]22,24,25,27 Catapan et al 33 found that video teleconsultation has numerous benefits. A few of the benefits are the ability to diagnose accurately, similar to face-to-face, the ability to deliver care without moving the patient, and the ability to adapt to current time constraints for health care.…”

“…34 EMS quality for pre-hospital care is also determined by how they respond to emergency calls from people who have experienced a medical emergency. 35 GoodSAM, a telemedicine-based application proposed by Linderoth et al 18 , connected EMS and bystanders using live videos. A 38.2% improvement in the paramedics' assessment occurred after the live videos.…”

“…The implementation of NCD management strategies is essential to the achievement of both the worldwide aim of a 25 percent relative decline in premature deaths due by NCDs by 2025 and the Sustainable Development Goal (SDG) target of a 33 percent drop by 2030 (Table 3). 30 Other emergency conditions discussed in included studies were pain-related diseases (n=1) 22 , pediatric difficult airway (n=1) 23 , and unspecified emergency conditions (n=5) 18,19,21,25,28 .…”

“…The audio-visual quality of the connection is sufficient, and there is a high degree of interrater reliability between the onboard and remote neurologists. Patients who were treated by neurologists aboard an MSU had shorter alarm-to-needle durations and a tendency toward a better functional result 3 Linderoth et al 18…”