InjuriesNCT05121649
Video-instructed First Aid in Emergency Medical Call Centers
An observational study of Injuries and Emergencies, run by Oslo Metropolitan University at 1 site in Norway.
Trial summary
Video streaming as an additional tool to telephone was introduced in some Norwegian emergency medical call centers during the spring of 2020. This allows the dispatchers to communicate with the caller through video streaming during emergency calls. Read more about this study
- Who is it for?
- Any ageHealthy volunteers can take part
- Conditions the study is for
- Injuries, Emergencies
- What is being tested?
- Video streaming
- How many people
- 174 participants
- Where
- 1 siteNorway
- Study dates
- 8 Nov 2021to 30 Jun 2023
- Phase
- Observational
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages Any age
- All sexes
- Healthy volunteers accepted
- Child, Adult, Older adult
Study population: Patients with injuries who meet the inclusion criteria in the health trusts cooperating as study areas.
Who may be able to join
- Patient with an injury,
- One or more bystanders at scene,
- One or more of the following first aid measures have been attempted or should have been attempted: Open airway, bleeding control, recovery position, hypothermia prevention.
Who cannot join
- The caller is at a different location than the patient
- Patients who are alone on scene and contacted the EMCC themselves
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Video Streaming in Norwegian Emergency Medical Call Centers as a Supplement to Telephone-instructed Bystander First Aid for Injured Patients
Video streaming as an additional tool to telephone was introduced in some Norwegian emergency medical call centers during the spring of 2020. This allows the dispatchers to communicate with the caller through video streaming during emergency calls. Some studies are conducted on this use of video streaming, but further research is needed.
In this study, the investigators have chosen to focus on potential effect from video streaming on bystander first aid for injured patients. The investigators have knowledge from preliminary results that dispatchers often find video streaming useful in emergency calls regarding injuries.
Read more
This study will investigate whether the use of video streaming might have an effect on the recognition rate by dispatchers on the need for bystander first aid for injured patients. In addition, the investigators will investigate whether video-instructions from dispatcher can improve bystander first aid quality.
The investigators will be using data collected by ambulance personnel including patients with injuries, as well as data from EMCC journals and audio logs.
Read the detailed description
Background:
Emergency Medical Communication Centres (EMCCs) in Norway receive more than 400 000 emergency calls every year, resulting in more than 250 000 ambulance dispatches. Emergency calls are answered by nurses or paramedics with special training, who by audio assesses the situation and decides on a response. Video streaming as a supplement to telephone in EMCC was introduced during springtime 2020 in Norway, and is independent of this study. The intended effect was to improve shared situational awareness between caller and operator, and thus improve the triage process. The video solution is live-only, and caller must give consent. Limited scientific evidence for such use exists, and even if video calls seems commonplace in society, the effects and acceptance in EMCCs has mainly been studied in simulated settings. Preliminary results from the early launch of video streaming showed that injured patients was one of the conditions where the dispatchers seemed to find video streaming useful. Previous studies by Bakke et.al investigating bystander first aid for injured patients, showed a potential for dispatchers in EMCCs to recognize more injured patients with the need for bystander first aid.
Aim:
This study focuses on the effect of video streaming in EMCCs on bystander first aid. The investigators aim to investigate whether dispatchers identifies the need for relevant first aid measures more frequently when using video streaming. The study will be conducted in several health trusts in Norway. In health trusts where video streaming not yet has been implemented in the EMCC, the investigators will collect data from period before video streaming is implemented, and after video streaming is implemented. From some health trusts in the study, video streaming already been implemented, and data collection will hence only be conducted for an after-period.
Methods and population size:
The number needed to treat is based on the studies by Bakke et al, as well it is based on one of our outcome goals: an aim for improvement of correctly identification of need for first aid by EMCC operator from 35% to 50%. Bakke et al included 355 cases during 18 months, which was done in a study area with approximately 270.500 inhabitants. For achievement of power of 0,80 and p-value <0,05 we need each study group to be 169, with the aimed improvement of 15%. Adding an estimate of missing cases of 10%, our study sample size for each group for this outcome measure is estimated to approximately 200 cases. For the outcome goal on quality improvement on first aid, which we aim the effect to be a raise in 20%, there is no aggregated outcome from previous studies to base an improvement on. The investigators therefore base our study sample size on number of cases included in Bakke's study. For this study to reach inclusion of 355 cases and with a study area with 1.150.000 inhabitants, the investigators need four months for each period. In Bakke's study, inclusion criteria were based on ICD-10 from hospital admissions. The investigators are therefore confident that the study will reach a minimum of 355 cases including patients not admitted to hospital as well. Based on these calculations on study sample sizes, the investigators estimate each of the before- and after periods to last 4 months, where cases before video implementation will be compared to calls after, separated by a wash-in period of 1-2 months.
Data collection and analyzes:
Patients will be included by ambulance personnel after the study's inclusion criteria. Ambulance personnel on scene will collect data through an internet-based questionnaire on need for first aid measures and quality of bystander first aid. In addition, data will be collected from EMCC journals and audio logs. This data will contain information on dispatchers recognition of first aid measures, as well as information on prehospital resources and time data. The investigators will also apply for data from the National Trauma Registry. Ambulance personnel participating in the data collection will complete an educational course about the questionnaire. The questionnaire used will be validated in a separate study. Analyzes of primary and secondary outcomes will be executed according to the ITT-principle. Uni- and multivariate regression analysis will be conducted.
Ethics:
The study is assessed by the Regional ethics committee in Norway as outside area of jurisdiction. It is approved by the Norwegian Center for Research Data and the Norwegian Health Directorate.
- Conditions
- Injuries, Emergencies
- Being tested
- Video streaming
- Keywords
- emergency call center, dispatcher, video, first aid, emergency call
- Medical subject headings
- Wounds and Injuries, Emergencies
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Video streamingOther
Video streaming as a supplement to telephone during emergency calls for dispatchers at EMCCs
| Study group | Role | What they receive |
|---|---|---|
| Before | Injured patients included in the study from health trusts where video streaming not yet has been implemented in the EMCC | |
| After | Injured patients included in the study from health trusts where video streaming has been implemented in the EMCC Receives: Other: Video streaming |
What is being measured
The primary outcome is the main question the study is designed to answer.
Dispatchers' recognition of relevant first aid measures
Number of patients where dispatchers in the EMCCs recognizes relevant first aid measures
Measured: Through study completion, an average of 1,5 years
Secondary outcomes (2)
First aid measures performed by bystander
Number of patients with first aid measures performed by bystander before the arrival of the first ambulance unit
Measured: Through study completion, an average of 1,5 years
Bystander first aid quality
Number of patients with first aid measures of high quality performed by bystander
Measured: Through study completion, an average of 1,5 years
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted16 Nov 2021
- Study start8 Nov 2021
- Primary completion28 Feb 2023
- Study completion30 Jun 2023
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (10)Papers the sponsor has linked to this study.
- Other trials for InjuriesStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Other
- Time perspective
- Prospective
- Enrolment
- 174 participants (actual)
Sponsor and investigators
- Lead sponsor
- Oslo Metropolitan University
- Sponsor type
- University, hospital or other
- Collaborators
- Vestre Viken Hospital Trust, Laerdal Foundation, Ostfold Hospital Trust, Oslo University Hospital, University Hospital of North Norway, Helse Stavanger HF
- Responsible party
- Principal investigator, Magnus Hjortdahl, Oslo Metropolitan University
- Investigators
- Magnus Hjortdahl, PhD, Principal investigator, OsloMet
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT05121649
- Sponsor's protocol ID
- 247264
- Status last verified
- Oct 2023
- First submitted
- 25 Oct 2021
- Last updated
- 1 Nov 2023
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Bakke HK, Steinvik T, Ruud H, Wisborg T. Effect and accuracy of emergency dispatch telephone guidance to bystanders in trauma: post-hoc analysis of a prospective observational study. Scand J Trauma Resusc Emerg Med. 2017 Mar 7;25(1):27. doi: 10.1186/s13049-016-0343-z.
PubMed 28270170Ecker H, Lindacher F, Adams N, Hamacher S, Wingen S, Schier R, Bottiger BW, Wetsch WA. Video-assisted cardiopulmonary resuscitation via smartphone improves quality of resuscitation: A randomised controlled simulation trial. Eur J Anaesthesiol. 2020 Apr;37(4):294-302. doi: 10.1097/EJA.0000000000001177.
PubMed 32073408Lee JS, Jeon WC, Ahn JH, Cho YJ, Jung YS, Kim GW. The effect of a cellular-phone video demonstration to improve the quality of dispatcher-assisted chest compression-only cardiopulmonary resuscitation as compared with audio coaching. Resuscitation. 2011 Jan;82(1):64-8. doi: 10.1016/j.resuscitation.2010.09.467. Epub 2010 Oct 30.
PubMed 21036457Ecker H, Wingen S, Hamacher S, Lindacher F, Bottiger BW, Wetsch WA. Evaluation Of CPR Quality Via Smartphone With A Video Livestream - A Study In A Metropolitan Area. Prehosp Emerg Care. 2021 Jan-Feb;25(1):76-81. doi: 10.1080/10903127.2020.1734122. Epub 2020 Mar 20.
PubMed 32091293Lin YY, Chiang WC, Hsieh MJ, Sun JT, Chang YC, Ma MH. Quality of audio-assisted versus video-assisted dispatcher-instructed bystander cardiopulmonary resuscitation: A systematic review and meta-analysis. Resuscitation. 2018 Feb;123:77-85. doi: 10.1016/j.resuscitation.2017.12.010. Epub 2017 Dec 12.
PubMed 29242057Linderoth G, Lippert F, Ostergaard D, Ersboll AK, Meyhoff CS, Folke F, Christensen HC. Live video from bystanders' smartphones to medical dispatchers in real emergencies. BMC Emerg Med. 2021 Sep 6;21(1):101. doi: 10.1186/s12873-021-00493-5.
PubMed 34488626Bakke HK, Steinvik T, Eidissen SI, Gilbert M, Wisborg T. Bystander first aid in trauma - prevalence and quality: a prospective observational study. Acta Anaesthesiol Scand. 2015 Oct;59(9):1187-93. doi: 10.1111/aas.12561. Epub 2015 Jun 19.
PubMed 26088860Melbye S, Hotvedt M, Bolle SR. Mobile videoconferencing for enhanced emergency medical communication - a shot in the dark or a walk in the park? -- A simulation study. Scand J Trauma Resusc Emerg Med. 2014 Jun 2;22:35. doi: 10.1186/1757-7241-22-35.
PubMed 24887256Yang CW, Wang HC, Chiang WC, Hsu CW, Chang WT, Yen ZS, Ko PC, Ma MH, Chen SC, Chang SC. Interactive video instruction improves the quality of dispatcher-assisted chest compression-only cardiopulmonary resuscitation in simulated cardiac arrests. Crit Care Med. 2009 Feb;37(2):490-5. doi: 10.1097/CCM.0b013e31819573a5.
PubMed 19114904Bolle SR, Hasvold P, Henriksen E. Video calls from lay bystanders to dispatch centers - risk assessment of information security. BMC Health Serv Res. 2011 Sep 30;11:244. doi: 10.1186/1472-6963-11-244.
PubMed 21958387
Study at a glance
From the registry record, last updated by the sponsor on 1 Nov 2023. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Video Streaming in Norwegian Emergency Medical Call Centers as a Supplement to Telephone-instructed Bystander First Aid for Injured Patients
- ClinicalTrials.gov ID
- NCT05121649
- Acronym / sponsor ID
- 247264
- Conditions
- Injuries, Emergencies
- Keywords
- emergency call center, dispatcher, video, first aid, emergency call
- Study type
- Observational
- Recruitment status
- Completed
- Enrolment
- 174 participants (actual)
- Lead sponsor
- Oslo Metropolitan UniversityUniversity, hospital or other
- Collaborators
- Vestre Viken Hospital Trust, Laerdal Foundation, Ostfold Hospital Trust, Oslo University Hospital, University Hospital of North Norway, Helse Stavanger HF
- Study start
- 8 Nov 2021 (actual)
- Primary completion
- 28 Feb 2023 (actual)
- Study completion
- 30 Jun 2023 (actual)
- First posted
- 16 Nov 2021 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Video streaming as an additional tool to telephone was introduced in some Norwegian emergency medical call centers during the spring of 2020. This allows the dispatchers to communicate with the caller through video streaming during emergency calls. Some studies are conducted on this use of video streaming, but further research is needed.
In this study, the investigators have chosen to focus on potential effect from video streaming on bystander first aid for injured patients. The investigators have knowledge from preliminary results that dispatchers often find video streaming useful in emergency calls regarding injuries.
This study will investigate whether the use of video streaming might have an effect on the recognition rate by dispatchers on the need for bystander first aid for injured patients. In addition, the investigators will investigate whether video-instructions from dispatcher can improve bystander first aid quality.
The investigators will be using data collected by ambulance personnel including patients with injuries, as well as data from EMCC journals and audio logs.
Detailed description
Background:
Emergency Medical Communication Centres (EMCCs) in Norway receive more than 400 000 emergency calls every year, resulting in more than 250 000 ambulance dispatches. Emergency calls are answered by nurses or paramedics with special training, who by audio assesses the situation and decides on a response. Video streaming as a supplement to telephone in EMCC was introduced during springtime 2020 in Norway, and is independent of this study. The intended effect was to improve shared situational awareness between caller and operator, and thus improve the triage process. The video solution is live-only, and caller must give consent. Limited scientific evidence for such use exists, and even if video calls seems commonplace in society, the effects and acceptance in EMCCs has mainly been studied in simulated settings. Preliminary results from the early launch of video streaming showed that injured patients was one of the conditions where the dispatchers seemed to find video streaming useful. Previous studies by Bakke et.al investigating bystander first aid for injured patients, showed a potential for dispatchers in EMCCs to recognize more injured patients with the need for bystander first aid.
Aim:
This study focuses on the effect of video streaming in EMCCs on bystander first aid. The investigators aim to investigate whether dispatchers identifies the need for relevant first aid measures more frequently when using video streaming. The study will be conducted in several health trusts in Norway. In health trusts where video streaming not yet has been implemented in the EMCC, the investigators will collect data from period before video streaming is implemented, and after video streaming is implemented. From some health trusts in the study, video streaming already been implemented, and data collection will hence only be conducted for an after-period.
Methods and population size:
The number needed to treat is based on the studies by Bakke et al, as well it is based on one of our outcome goals: an aim for improvement of correctly identification of need for first aid by EMCC operator from 35% to 50%. Bakke et al included 355 cases during 18 months, which was done in a study area with approximately 270.500 inhabitants. For achievement of power of 0,80 and p-value <0,05 we need each study group to be 169, with the aimed improvement of 15%. Adding an estimate of missing cases of 10%, our study sample size for each group for this outcome measure is estimated to approximately 200 cases. For the outcome goal on quality improvement on first aid, which we aim the effect to be a raise in 20%, there is no aggregated outcome from previous studies to base an improvement on. The investigators therefore base our study sample size on number of cases included in Bakke's study. For this study to reach inclusion of 355 cases and with a study area with 1.150.000 inhabitants, the investigators need four months for each period. In Bakke's study, inclusion criteria were based on ICD-10 from hospital admissions. The investigators are therefore confident that the study will reach a minimum of 355 cases including patients not admitted to hospital as well. Based on these calculations on study sample sizes, the investigators estimate each of the before- and after periods to last 4 months, where cases before video implementation will be compared to calls after, separated by a wash-in period of 1-2 months.
Data collection and analyzes:
Patients will be included by ambulance personnel after the study's inclusion criteria. Ambulance personnel on scene will collect data through an internet-based questionnaire on need for first aid measures and quality of bystander first aid. In addition, data will be collected from EMCC journals and audio logs. This data will contain information on dispatchers recognition of first aid measures, as well as information on prehospital resources and time data. The investigators will also apply for data from the National Trauma Registry. Ambulance personnel participating in the data collection will complete an educational course about the questionnaire. The questionnaire used will be validated in a separate study. Analyzes of primary and secondary outcomes will be executed according to the ITT-principle. Uni- and multivariate regression analysis will be conducted.
Ethics:
The study is assessed by the Regional ethics committee in Norway as outside area of jurisdiction. It is approved by the Norwegian Center for Research Data and the Norwegian Health Directorate.
Study design
- Observational model
- Other
- Time perspective
- Prospective
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Before | – | –Injured patients included in the study from health trusts where video streaming not yet has been implemented in the EMCC |
| After | – | Other: Video streamingInjured patients included in the study from health trusts where video streaming has been implemented in the EMCC |
Who may qualify
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Child, Adult, Older adult
- Study population
- Patients with injuries who meet the inclusion criteria in the health trusts cooperating as study areas.
Key inclusion criteria (3 listed)
- Patient with an injury,
- One or more bystanders at scene,
- One or more of the following first aid measures have been attempted or should have been attempted: Open airway, bleeding control, recovery position, hypothermia prevention.
Key exclusion criteria (2 listed)
- The caller is at a different location than the patient
- Patients who are alone on scene and contacted the EMCC themselves
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Video streamingVideo streaming as a supplement to telephone during emergency calls for dispatchers at EMCCs | Other | After |
Primary outcome
Dispatchers' recognition of relevant first aid measures
Time frame: Through study completion, an average of 1,5 years
Number of patients where dispatchers in the EMCCs recognizes relevant first aid measures
2 secondary outcomes
First aid measures performed by bystander
Time frame: Through study completion, an average of 1,5 years
Bystander first aid quality
Time frame: Through study completion, an average of 1,5 years
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 1 Nov 2023.
- Background: PubMed 28270170Bakke HK, Steinvik T, Ruud H, Wisborg T. Effect and accuracy of emergency dispatch telephone guidance to bystanders in trauma: post-hoc analysis of a prospective observational study. Scand J Trauma Resusc Emerg Med. 2017 Mar 7;25(1):27. doi: 10.1186/s13049-016-0343-z.
- Background: PubMed 32073408Ecker H, Lindacher F, Adams N, Hamacher S, Wingen S, Schier R, Bottiger BW, Wetsch WA. Video-assisted cardiopulmonary resuscitation via smartphone improves quality of resuscitation: A randomised controlled simulation trial. Eur J Anaesthesiol. 2020 Apr;37(4):294-302. doi: 10.1097/EJA.0000000000001177.
- Background: PubMed 21036457Lee JS, Jeon WC, Ahn JH, Cho YJ, Jung YS, Kim GW. The effect of a cellular-phone video demonstration to improve the quality of dispatcher-assisted chest compression-only cardiopulmonary resuscitation as compared with audio coaching. Resuscitation. 2011 Jan;82(1):64-8. doi: 10.1016/j.resuscitation.2010.09.467. Epub 2010 Oct 30.
- Background: PubMed 32091293Ecker H, Wingen S, Hamacher S, Lindacher F, Bottiger BW, Wetsch WA. Evaluation Of CPR Quality Via Smartphone With A Video Livestream - A Study In A Metropolitan Area. Prehosp Emerg Care. 2021 Jan-Feb;25(1):76-81. doi: 10.1080/10903127.2020.1734122. Epub 2020 Mar 20.
- Background: PubMed 29242057Lin YY, Chiang WC, Hsieh MJ, Sun JT, Chang YC, Ma MH. Quality of audio-assisted versus video-assisted dispatcher-instructed bystander cardiopulmonary resuscitation: A systematic review and meta-analysis. Resuscitation. 2018 Feb;123:77-85. doi: 10.1016/j.resuscitation.2017.12.010. Epub 2017 Dec 12.
- Background: PubMed 34488626Linderoth G, Lippert F, Ostergaard D, Ersboll AK, Meyhoff CS, Folke F, Christensen HC. Live video from bystanders' smartphones to medical dispatchers in real emergencies. BMC Emerg Med. 2021 Sep 6;21(1):101. doi: 10.1186/s12873-021-00493-5.
- Background: PubMed 26088860Bakke HK, Steinvik T, Eidissen SI, Gilbert M, Wisborg T. Bystander first aid in trauma - prevalence and quality: a prospective observational study. Acta Anaesthesiol Scand. 2015 Oct;59(9):1187-93. doi: 10.1111/aas.12561. Epub 2015 Jun 19.
- Background: PubMed 24887256Melbye S, Hotvedt M, Bolle SR. Mobile videoconferencing for enhanced emergency medical communication - a shot in the dark or a walk in the park? -- A simulation study. Scand J Trauma Resusc Emerg Med. 2014 Jun 2;22:35. doi: 10.1186/1757-7241-22-35.
- Background: PubMed 19114904Yang CW, Wang HC, Chiang WC, Hsu CW, Chang WT, Yen ZS, Ko PC, Ma MH, Chen SC, Chang SC. Interactive video instruction improves the quality of dispatcher-assisted chest compression-only cardiopulmonary resuscitation in simulated cardiac arrests. Crit Care Med. 2009 Feb;37(2):490-5. doi: 10.1097/CCM.0b013e31819573a5.
- Background: PubMed 21958387Bolle SR, Hasvold P, Henriksen E. Video calls from lay bystanders to dispatch centers - risk assessment of information security. BMC Health Serv Res. 2011 Sep 30;11:244. doi: 10.1186/1472-6963-11-244.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Magnus Hjortdahl, PhD principal investigator
OsloMet
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Injuries and Emergencies, run by Oslo Metropolitan University at 1 site in Norway.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 3 inclusion and 2 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 1 Nov 2023. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Norway. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Dispatchers' recognition of relevant first aid measures (time frame: Through study completion, an average of 1,5 years). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT05121649, which also lists 10 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 1 Nov 2023.