Effectiveness of an Online Body Camera System for Medical Oversight in Prehospital Emergency Care: An 11-Year Retrospective Cohort Study
学术急诊医学档案,
卷 14 编号 1 (2026),
1 十月 2025
,
第 e10 页
https://doi.org/10.22037/aaem.v14i1.2916
摘要
Introduction: The online body camera system (OBCS) integrates telemedicine technology with real-time monitoring of on-scene operations, direct online medical direction, and coordinated patient care. This study aimed to evaluate its effectiveness compared with the traditional telephone-based medical oversight system.
Methods: This retrospective cohort study evaluated the effectiveness of OBCS in prehospital emergency care of Ramathibodi Hospital by comparing outcomes (survival rate, length of stay) between the traditional telephone-based (2014–2021) and the OBCS periods (2022–2024) in emergency medical operation unit.
Results: This 11-year retrospective cohort study analyzed 5,721 prehospital emergency care cases (3,398 cases managed under the traditional telephone-based system and 2,323 cases managed under the OBCS). The findings indicate that the implementation of the OBCS significantly improved overall survival to emergency department (ED) arrival (adjusted odds ratio (aOR) = 8.32, 95% CI: 1.47–47.14, P = 0.017), particularly among out-of-hospital cardiac arrest (OHCA) patients (aOR = 7.99, 95% CI: 1.28–50.03, P = 0.026). However, the new system did not result in significant improvements in survival to hospital admission or survival to hospital discharge. Furthermore, the length of stay (LOS) in the ED, intensive care unit (ICU), and overall hospital setting remained unchanged.
Conclusions: The OBCS significantly enhanced survival to ED arrival, particularly among OHCA patients. However, the LOS in the ED, ICU, and overall hospital setting remained unchanged.
- Emergency Medical Services
- Telemedicine
- Medical Director
- Telecommunications
- prehospital emergency care
##submission.howToCite##
参考
1. Wilson MH, Habig K, Wright C, Hughes A, Davies G, Imray CH. Pre-hospital emergency medicine. Lancet. 2015;386(10012):2526-34.
2. McCoy AM, Morris D, Tanaka K, Wright A, Guyette FX, Martin-Gill C. Prehospital Noninvasive Ventilation: An NAEMSP Position Statement and Resource Document. Prehosp Emerg Care. 2022;26(sup1):80-7.
3. Wang D, Deng L, Zhang R, Zhou Y, Zeng J, Jiang H. Efficacy of intraosseous access for trauma resuscitation: a systematic review and meta-analysis. World J Emerg Surg. 2023;18(1):17.
4. Perkins GD, Lall R, Quinn T, Deakin CD, Cooke MW, Horton J, et al. Mechanical versus manual chest compression for out-of-hospital cardiac arrest (PARAMEDIC): a pragmatic, cluster randomised controlled trial. Lancet. 2015;385(9972):947-55.
5. Weber JE, Ebinger M, Rozanski M, Waldschmidt C, Wendt M, Winter B, et al. Prehospital thrombolysis in acute stroke: results of the PHANTOM-S pilot study. Neurology. 2013;80(2):163-8.
6. Jenkins L, Johnston T, Armour R, Maria S. Informing Utstein-style reporting guidelines for prehospital thrombolysis: A scoping review. Australas Emerg Care. 2024;27(2):148-54.
7. Knudsen L, Sandberg M. Ultrasound in pre-hospital care. Acta Anaesthesiol Scand. 2011;55(4):377-8.
8. Purvis MV, Rooks H, Young Lee J, Longerich S, Kahn SA. Prehospital hydroxocobalamin for inhalation injury and cyanide toxicity in the United States - analysis of a database and survey of ems providers. Ann Burns Fire Disasters. 2017;30(2):126-8.
9. Shakur H, Roberts I, Bautista R, Caballero J, Coats T, Dewan Y, et al. Effects of tranexamic acid on death, vascular occlusive events, and blood transfusion in trauma patients with significant haemorrhage (CRASH-2): a randomised, placebo-controlled trial. Lancet. 2010;376(9734):23-32.
10. Ker K, Roberts I, Shakur H, Coats TJ. Antifibrinolytic drugs for acute traumatic injury. Cochrane Database Syst Rev. 2015;2015(5):Cd004896.
11. Lendrum RA, Perkins Z, Marsden M, Cochran C, Davenport R, Chege F, et al. Prehospital Partial Resuscitative Endovascular Balloon Occlusion of the Aorta for Exsanguinating Subdiaphragmatic Hemorrhage. JAMA Surg. 2024;159(9):998-1007.
12. Lendrum R, Perkins Z, Chana M, Marsden M, Davenport R, Grier G, et al. Reply to: Prehospital REBOA: Time to clearly define the relevant indications. Resuscitation. 2019;142:191-2.
13. Macku D, Hedvicak P, Quinn JM, Bencko V. Prehospital Medicine and the Future Will ECMO Ever Play a Role? J Spec Oper Med. 2018;18(1):133-8.
14. Seesink J, van der Wielen W, Dos Reis Miranda D, Moors XJR. Successful prehospital ECMO in drowning resuscitation after prolonged submersion. Resusc Plus. 2024;19:100685.
15. Su JS, Quinn E. EMS Telemedicine in the Prehospital Setting. StatPearls. Treasure Island (FL): StatPearls Publishing; 2025.
16. Quadflieg LTM, Beckers SK, Bergrath S, Brockert AK, Schröder H, Sommer A, et al. Comparing the diagnostic concordance of tele-EMS and on-site-EMS physicians in emergency medical services: a retrospective cohort study. Sci Rep. 2020;10(1):17982.
17. Langabeer JR, 2nd, Gonzalez M, Alqusairi D, Champagne-Langabeer T, Jackson A, Mikhail J, et al. Telehealth-Enabled Emergency Medical Services Program Reduces Ambulance Transport to Urban Emergency Departments. West J Emerg Med. 2016;17(6):713-20.
18. Bilotta M, Sigal AP, Shah A, Martin A, Schlappy DA, Sorensen G, et al. A Novel Use of Prehospital Telemedicine to Decrease Door to Computed Tomography Results in Acute Strokes. J Healthc Qual. 2020;42(5):264-8.
19. Bergrath S, Brokmann JC, Beckers S, Felzen M, Czaplik M, Rossaint R. Implementation of a full-scale prehospital telemedicine system: evaluation of the process and systemic effects in a pre-post intervention study. BMJ Open. 2021;11(3):e041942.
20. Amadi-Obi A, Gilligan P, Owens N, O'Donnell C. Telemedicine in pre-hospital care: a review of telemedicine applications in the pre-hospital environment. Int J Emerg Med. 2014;7:29.
21. Cabral E, Castro WRS, Florentino DRM, Viana DA, Costa Junior JFD, Souza RP, et al. Response time in the emergency services. Systematic review. Acta Cir Bras. 2018;33(12):1110-21.
22. Pham H, Puckett Y, Dissanaike S. Faster on-scene times associated with decreased mortality in Helicopter Emergency Medical Services (HEMS) transported trauma patients. Trauma Surg Acute Care Open. 2017;2(1):e000122.
23. Olascoaga Arrate A, Freijo Guerrero MM, Fernández Maiztegi C, Azkune Calle I, Silvariño Fernández R, Fernández Rodríguez M, et al. Use of emergency medical transport and impact on time to care in patients with ischaemic stroke. Neurologia (Engl Ed). 2019;34(2):80-8.
24. Waller M, Stotler C. Telemedicine: a Primer. Curr Allergy Asthma Rep. 2018;18(10):54.
25. Felzen M, Beckers SK, Kork F, Hirsch F, Bergrath S, Sommer A, et al. Utilization, Safety, and Technical Performance of a Telemedicine System for Prehospital Emergency Care: Observational Study. J Med Internet Res. 2019;21(10):e14907.
26. Yperzeele L, Van Hooff RJ, De Smedt A, Valenzuela Espinoza A, Van Dyck R, Van de Casseye R, et al. Feasibility of AmbulanCe-Based Telemedicine (FACT) study: safety, feasibility and reliability of third generation in-ambulance telemedicine. PLoS One. 2014;9(10):e110043.
27. Tanaka Y, Taniguchi J, Wato Y, Yoshida Y, Inaba H. The continuous quality improvement project for telephone-assisted instruction of cardiopulmonary resuscitation increased the incidence of bystander CPR and improved the outcomes of out-of-hospital cardiac arrests. Resuscitation. 2012;83(10):1235-41.
28. Song KJ, Shin SD, Park CB, Kim JY, Kim DK, Kim CH, et al. Dispatcher-assisted bystander cardiopulmonary resuscitation in a metropolitan city: a before-after population-based study. Resuscitation. 2014;85(1):34-41.
29. Bolle SR, Scholl J, Gilbert M. Can video mobile phones improve CPR quality when used for dispatcher assistance during simulated cardiac arrest? Acta Anaesthesiol Scand. 2009;53(1):116-20.
30. Meinich-Bache Ø, Engan K, Birkenes TS, Myklebust H. Real-Time Chest Compression Quality Measurements by Smartphone Camera. J Healthc Eng. 2018;2018:6241856.
31. Agarwal AK, Gaieski DF, Perman SM, Leary M, Delfin G, Abella BS, et al. Telemedicine REsuscitation and Arrest Trial (TREAT): A feasibility study of real-time provider-to-provider telemedicine for the care of critically ill patients. Heliyon. 2016;2(4):e00099.
32. Taqui A, Cerejo R, Itrat A, Briggs FB, Reimer AP, Winners S, et al. Reduction in time to treatment in prehospital telemedicine evaluation and thrombolysis. Neurology. 2017;88(14):1305-12.
33. Itrat A, Taqui A, Cerejo R, Briggs F, Cho SM, Organek N, et al. Telemedicine in Prehospital Stroke Evaluation and Thrombolysis: Taking Stroke Treatment to the Doorstep. JAMA Neurol. 2016;73(2):162-8.
34. Song KJ, Shin SD, Hong KJ, Cheon KW, Shin I, Song SW, et al. Clinical applicability of real-time, prehospital image transmission for FAST (Focused Assessment with Sonography for Trauma). J Telemed Telecare. 2013;19(8):450-5.
35. Sykora R, Renza M, Ruzicka J, Bakurova P, Kukacka M, Smetana J, et al. Audiovisual Consults by Paramedics to Reduce Hospital Transport After Low-Urgency Calls: Randomized Controlled Trial. Prehosp Disaster Med. 2020;35(6):656-62.
36. Yoon J, Kym D, Hur J, Won JH, Yim H, Cho YS, et al. Time-varying discrimination accuracy of longitudinal biomarkers for the prediction of mortality compared to assessment at fixed time point in severe burns patients. BMC Emerg Med. 2021;21(1):1.
37. Chan AW, Kornder J, Elliott H, Brown RI, Dorval JF, Charania J, et al. Improved survival associated with pre-hospital triage strategy in a large regional ST-segment elevation myocardial infarction program. JACC Cardiovasc Interv. 2012;5(12):1239-46.
38. Charash WE, Caputo MP, Clark H, Callas PW, Rogers FB, Crookes BA, et al. Telemedicine to a moving ambulance improves outcome after trauma in simulated patients. J Trauma. 2011;71(1):49-54; discussion 5.
39. Schröder H, Beckers SK, Ogrodzki K, Borgs C, Ziemann S, Follmann A, et al. Tele-EMS physicians improve life-threatening conditions during prehospital emergency missions. Sci Rep. 2021;11(1):14366.
40. Raaber N, Bøtker MT, Riddervold IS, Christensen EF, Emmertsen NC, Grøfte T, et al. Telemedicine-based physician consultation results in more patients treated and released by ambulance personnel. Eur J Emerg Med. 2018;25(2):120-7.
41. Kim YK, Kim KY, Lee KH, Kim SC, Kim H, Hwang SO, et al. Clinical outcomes on real-time telemetry system in developing emergency medical service system. Telemed J E Health. 2011;17(4):247-53.
42. Shah MN, Morris D, Jones CM, Gillespie SM, Nelson DL, McConnochie KM, et al. A qualitative evaluation of a telemedicine-enhanced emergency care program for older adults. J Am Geriatr Soc. 2013;61(4):571-6.
43. Delgoshaei B, Mobinizadeh M, Mojdekar R, Afzal E, Arabloo J, Mohamadi E. Telemedicine: A systematic review of economic evaluations. Med J Islam Repub Iran. 2017;31:113.
44. Langabeer JR, 2nd, Champagne-Langabeer T, Alqusairi D, Kim J, Jackson A, Persse D, et al. Cost-benefit analysis of telehealth in pre-hospital care. J Telemed Telecare. 2017;23(8):747-51.
- 摘要 ##plugins.themes.ojsPlusA.frontend.article.viewed##: 215 ##plugins.themes.ojsPlusA.frontend.article.times##
- pdf (English) ##plugins.themes.ojsPlusA.frontend.article.downloaded##: 162 ##plugins.themes.ojsPlusA.frontend.article.times##
##plugins.themes.ojsPlusA.frontend.article.downloadstatastics##
##plugins.block.makeSubmission.linkLabel##
SJR
COPE
