Video Streaming or Telephone Communication During Emergency Medical Services Dispatch Calls: A Cluster Randomized...

Area of Science:

• Emergency medicine
• Health services research
• Clinical informatics

Background:

• Video streaming during emergency medical calls shows potential for improving triage precision and resource allocation.
• However, its clinical safety and impact on patient outcomes in randomized trials are not well-established.

Purpose of the Study:

• To evaluate if video streaming during emergency calls reduces highest-urgency ambulance dispatches.
• To assess the safety of video streaming by examining 24-hour hospital admissions for non-conveyed patients, mortality, and intensive care unit (ICU) admissions.

Main Methods:

• A cluster randomized clinical trial was conducted at a single emergency medical dispatch center.
• Dispatchers were randomized to either telephone-only communication (control) or video streaming (intervention) for managing emergency calls.
• Data were analyzed using an intention-to-treat approach.

Main Results:

• Video streaming led to a 5.0% absolute reduction in highest-urgency ambulance dispatches compared to the control group (P=.049).
• Hospital admissions within 24 hours for initially non-conveyed patients decreased by 2.0% (P=.03) in the video streaming group.
• Dispatch times were slightly longer in the video streaming group (0.5 minutes increase, P=.02), with no significant differences in mortality or ICU admissions.

Conclusions:

• Video streaming during emergency calls effectively reduced the frequency of highest-urgency ambulance dispatches and lowered hospital admissions among non-conveyed patients.
• While dispatch times increased slightly, the findings suggest video streaming can enhance triage accuracy and optimize the use of hospital and prehospital resources.
• Further research may explore optimizing implementation to mitigate increased dispatch times.