AMSU: Mobile Stroke Unit for Pre-hospital Emergency Care
Study Details
Study Description
Brief Summary
Emergency department overcrowding is a major challenge in medicine, leading to a delay in diagnosis and treatment for the patient due to long waiting times. This is very relevant for diseases like acute stroke and other emergencies. The Advanced Mobile Stroke Unit is an ambulance equipped with additional devices to diagnose and treat patients at the emergency site. Patients with less severe conditions can be diagnosed and safely left at home. The objectives of this project are to investigate whether the Advanced Mobile Stroke Unit compared to a normal ambulance enables more accurate triage of patients (treatment at home vs hospital vs specialist vs A&E). The Advanced Mobile Stroke Unit ambulance will be used in a random order of weeks and this will be compared to weeks with normal ambulances. The study will be carried out by the East of England Ambulance Service NHS Trust in collaboration with the East Suffolk and North Essex NHS Foundation Trust in the East of England. The project is a collaboration with Saarland University, Germany,
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
N/A |
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Other: Advanced Mobile Stroke Unit Prehospital treatment of patients with an advanced Mobile Stroke Unit. The advanced Mobile Stroke Unit is an ambulance equipped with a computed tomography scanner, and additional diagnostic devices, such as point-of-care-laboratory and telemedicine to enable the team to diagnose and initiated specialised treatment of emergency patients at the emergency site. |
Other: Management
Comparison if different strategies to manage acute emergencies in the pre-hospital setting.
|
| Other: Conventional ambulance Prehospital emergency care with conventional ambulances. |
Other: Management
Comparison if different strategies to manage acute emergencies in the pre-hospital setting.
|
Outcome Measures
Primary Outcome Measures
- Number of patients requiring hospital attendance within 4h of acute emergency situation [acute emergency situation (4 hours)]
Patient attendance at hospital related to the emergency call (within 4hours) will be assessed
Secondary Outcome Measures
- Emergency management metrics [acute emergency situation (within 4 hours after call)]
Time metrics related to the emergency call treatment (within 4 hours after call)
- Clinical Outcome on day 90 [90 days]
modified Rankin for patients with brain disease
- Clinical Outcome on day 90 [90 days]
EQ-5D5L
Other Outcome Measures
- Safety endpoints [90 days]
Mortality rate within 90 days
- Safety endpoints [24 hours]
Number of patients with re-contact to EMS within 24h after emergency call
- Safety endpoints [90 days]
Number of patients with (serious) adverse events within 90 days
- Health economic analysis [acute phase related to the emergency call (12 hours)]
Incremental cost-effectiveness ratio (ICER), treatment costs and health states will be evaluated for each therapy option, for the acute phase (within 12 hours)
- Health economic analysis [1 year after the acute emergency call]
Incremental cost-effectiveness ratio (ICER), treatment costs and health states will be evaluated for each therapy option after 1 year
Eligibility Criteria
Criteria
Inclusion Criteria:
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acute emergency patients 18 years or older, who are identified via the national emergency telephone number 999 or 111with suspected severe medical emergency condition, which is categorised as: breathing problem, seizure, falls with head trauma, headache, sick person with suspected infection, stroke, unconsciousness
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calls Monday to Friday 9am to 5 pm
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written informed consent
Exclusion Criteria:
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terminally ill patients
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pregnant patients
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patients in cardiac arrest
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patients in custody of Her Majesty's prison service
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | East of England Ambulance Service NHS Trust | Melbourn | United Kingdom |
Sponsors and Collaborators
- Daniel Phillips
- Universität des Saarlandes
- East Suffolk and North Essex NHS Foundation Trust
Investigators
- Principal Investigator: Silke Walter, Prof, Universität des Saarlandes, EEAST
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- 292195