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. 2025 May 22;15(1):17740.
doi: 10.1038/s41598-025-01850-1.

Telemedicine for prehospital respiratory emergencies in a retrospective quality analysis

Alexander Beierle  1   2 , Syrina Beierle  3   4 , Mark Pitsch  3   4 , Despina Panagiotidis  3   4 , Jan Larmann  3 , Stefan K Beckers  3   4 , Marc Felzen  3   4 , Hanna Schröder  3   4
Affiliations

Telemedicine for prehospital respiratory emergencies in a retrospective quality analysis

Alexander Beierle et al. Sci Rep. .

Abstract

Respiratory distress is a common reason for emergency medical service (EMS) physicians to be prehospitally involved. While the availability of telemedical EMS systems increases continuously, there is a gap in research regarding respiratory emergencies in the context of prehospital telemedicine. The aim of this study is to evaluate the quality of care provided in prehospital respiratory emergencies, managed through a tele-EMS system with a specialized EMS physician. Tele-EMS physician missions from 01/01/2019 to 12/31/2021 in Aachen, Germany, were analyzed. Adult patients presenting with dyspnea, peripheral oxygen saturation < 94%, respiratory rate > 19/min, or any combination of these factors, were included (n = 2234). Data were derived from mission protocols recorded by the attending tele-EMS physicians. Significant changes (p < 0.001) in vital parameters towards physiological ranges were observed. For the most common diagnoses, a significant improvement in patient condition was achieved with the use of appropriate medications. In 14 cases (0.63%), an onsite-EMS physician was requested. These cases were confirmed to involve unstable patients who required intervention of an onsite-EMS physician. The tele-EMS physician effectively bridged the time until arrival of the physician. Overall, the study demonstrated that respiratory emergencies were effectively managed using the tele-EMS physician system.

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Conflict of interest statement

Declarations. Competing interests: S.B., M.P., D.P., S.K.B., M.F., and H.S. were employed at University Hospital RWTH Aachen, Department of Anesthesiology, which initiated the research, development, and implementation of the tele-EMS system. The other authors declare no conflicts of interest.

Figures

Fig. 1
Fig. 1
Inclusion and exclusion criteria. EMS = emergency medical service; SpO2 = peripheral oxygen saturation.
Fig. 2
Fig. 2
(a) NACA score. (b) Diagnosis. EMS = emergency medical service; NACA = National Advisory Committee for Aeronautics.
Fig. 3
Fig. 3
Vital signs. CI = confidence interval; SpO2 = peripheral oxygen saturation; * represents significant difference (p < 0.001).
Fig. 4
Fig. 4
Categorization of diagnoses and according measurements. ACS = acute coronary syndrome; SpO2 = peripheral oxygen saturation; * represents significant difference (p < 0.001).
See this image and copyright information in PMC

References

    1. Prekker, M. E. et al. The epidemiology and outcome of prehospital respiratory distress. Acad. Emerg. Med.21, 543–550 (2014). - PMC - PubMed
    1. Ray, P. et al. Acute respiratory failure in the elderly: Etiology, emergency diagnosis and prognosis. Crit. Care10, R82 (2006). - PMC - PubMed
    1. Bøtker, M. T. et al. Long-term mortality of emergency medical services patients. Ann. Emerg. Med.70, 366-373.e3 (2017). - PubMed
    1. Spörl, P., Beckers, S. K., Rossaint, R., Felzen, M. & Schroder, H. Shedding light into the black box of out-of hospital respiratory distress—A retrospective cohort analysis of discharge diagnoses, prehospital diagnostic accuracy, and predictors of mortality. PLoS ONE17, e0271982 (2022). - PMC - PubMed
    1. Newman-Toker, D. E. et al. Burden of serious harms from diagnostic error in the USA. BMJ Qual. Saf.33, 109–120 (2023). - PMC - PubMed