Simulation Trial of Telemedical Support for Paramedics

NCT ID: NCT06441760

Last Updated: 2025-07-14

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

420 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-07-10

Study Completion Date

2028-12-31

Brief Summary

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In the United States, the current standard of prehospital (i.e. outside of hospitals) emergency care for children with life-threatening illnesses in the community includes remote physician support for paramedics providing life-saving therapy while transporting the child to the hospital. Most prehospital emergency medical services (EMS) agencies use radio-based (audio only) communication between paramedics and physicians to augment this care. However, this communication strategy is inherently limited as the remote physician cannot visualize the patient for accurate assessment and to direct treatment.

The purpose of this pilot randomized controlled trial (RCT) is to evaluate whether use of a 2-way audiovisual connection with a pediatric emergency medicine expert (intervention = "telemedical support") will improve the quality of care provided by paramedics to infant simulator mannequins with life threatening illness (respiratory failure). Paramedics receiving real-time telemedical support by a pediatric expert may provide better care due to decreased cognitive burden, critical action checking, protocol verification, and error correction. Because real pediatric life-threatening illnesses are rare, high stakes events and involve a vulnerable population (children), this RCT will test the effect of the intervention on paramedic performance in simulated cases of pediatric medical emergencies.

The two specific aims for this research are:

* Aim 1: To test the intervention efficacy by determining if there is a measurable difference in the frequency of serious safety events between study groups
* Aim 2: To compare two safety event detection methods, medical record review, and video review

Detailed Description

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Conditions

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Emergencies Cardiopulmonary Arrest Acute Respiratory Failure Status Epilepticus

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Single blind, parallel arm, multicenter simulation RCT of prehospital teams from 9 Pediatric Emergency Care Applied Research Network (PECARN) and non-PECARN sites
Primary Study Purpose

HEALTH_SERVICES_RESEARCH

Blinding Strategy

SINGLE

Outcome Assessors
All participants will be blinded to the simulated transport scenarios.

Study Groups

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Teleconsultation video arm with PEM physicians

Emergency Medical Services (EMS) providers randomized into this arm will receive video teleconsultation with Pediatric Emergency Medicine (PEM) physicians.

Group Type EXPERIMENTAL

Video teleconsultation

Intervention Type OTHER

Each team will participate in 4 video-recorded simulated transports in fully equipped ambulances. Each team will provide resuscitative care in 4 simulated high-risk pediatric transports. EMS personnel will provide care in the ambulance while PEM physicians will provide medical direction remotely using video to communicate with EMS personnel via tablet devices.

Audio support arm with EM physicians

EMS providers randomized into this arm will receive audio support by usual care Emergency Medicine (EM) physicians.

Group Type ACTIVE_COMPARATOR

Audio support

Intervention Type OTHER

Each team will participate in 4 video-recorded simulated transports in fully equipped ambulances. Each team will provide resuscitative care in 4 simulated high-risk pediatric transports. EMS personnel will provide care in the ambulance while EM physicians will provide medical direction remotely using audio to communicate with EMS personnel via tablet devices.

Interventions

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Video teleconsultation

Each team will participate in 4 video-recorded simulated transports in fully equipped ambulances. Each team will provide resuscitative care in 4 simulated high-risk pediatric transports. EMS personnel will provide care in the ambulance while PEM physicians will provide medical direction remotely using video to communicate with EMS personnel via tablet devices.

Intervention Type OTHER

Audio support

Each team will participate in 4 video-recorded simulated transports in fully equipped ambulances. Each team will provide resuscitative care in 4 simulated high-risk pediatric transports. EMS personnel will provide care in the ambulance while EM physicians will provide medical direction remotely using audio to communicate with EMS personnel via tablet devices.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Certified Emergency Medical Technicians (EMTs), Advanced EMTs (AEMTs), and Paramedics (EMT-Ps) who provide direct scene response.
* Board-certified Pediatric Emergency Medicine (PEM) and Emergency Medicine (EM) physicians whose practice includes online medical support for EMS are eligible.
* The control arm will include physicians who provide radio/telephone support in usual care at each site. In the intervention arm, experts will be PEM with/without EMS board-certification as they have relevant pediatric training and experience.

Exclusion Criteria

* EMS personnel providing interfacility transport and/or pediatric specialty transport
* Resident physicians-in-training
* Non-physician providers
Minimum Eligible Age

21 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)

NIH

Sponsor Role collaborator

Boston Medical Center

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Tehnaz Boyle, MD PhD

Role: PRINCIPAL_INVESTIGATOR

Bosotn Medical Center, Pediatrics Department

Locations

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Children's Hospital Colorado, University of Colorado Denver Anschutz Medical Campus

Aurora, Colorado, United States

Site Status NOT_YET_RECRUITING

Yale University

New Haven, Connecticut, United States

Site Status RECRUITING

BostonMedical Center

Boston, Massachusetts, United States

Site Status RECRUITING

University of Utah

Salt Lake City, Utah, United States

Site Status NOT_YET_RECRUITING

Countries

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United States

Central Contacts

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Tehnaz Boyle, MD PhD

Role: CONTACT

617-414-3682

Divya Gumudavelly, MPH

Role: CONTACT

248-787-0876

Facility Contacts

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Kathleen Adelgais, MD

Role: primary

303-724-1055

Marc Auerbach, MD

Role: primary

203-785-4688

Tehnaz Boyle, MD PhD

Role: primary

617-414-3682

Bradley Barney, PhD

Role: primary

801-581-3655

Other Identifiers

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1R01HD115574-01

Identifier Type: NIH

Identifier Source: secondary_id

View Link

H-44972

Identifier Type: -

Identifier Source: org_study_id

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