The SEE-IT Trial: emergency medical servicesStreamingEnabledEvaluationInTrauma: study protocol for an interventional feasibility randomised controlled trial

Abstract

IntroductionAccurate and timely dispatch of emergency medical services (EMS) is vital due to limited resources and patients’ risk of mortality and morbidity increasing with time. Currently, most UK emergency operations centres (EOCs) rely on audio calls and accurate descriptions of the incident and patients’ injuries from lay 999 callers. If dispatchers in the EOCs could see the scene via live video streaming from the caller’s smartphone, this may enhance their decision making and enable quicker and more accurate dispatch of EMS. The main aim of this feasibility randomised controlled trial (RCT) is to assess the feasibility of conducting a definitive RCT to assess the clinical and cost effectiveness of using live streaming to improve targeting of EMS.Methods and analysisThe SEE-IT Trial is a feasibility RCT with a nested process evaluation. The study also has two observational substudies: (1) in an EOC that routinely uses live streaming to assess the acceptability and feasibility of live streaming in a diverse inner-city population and (2) in an EOC that does not currently use live streaming to act as a comparator site regarding the psychological well-being of EOC staff using versus not using live streaming.Ethics and disseminationThe study was approved by the Health Research Authority on 23 March 2022 (ref: 21/LO/0912), which included NHS Confidentiality Advisory Group approval received on 22 March 2022 (ref: 22/CAG/0003). This manuscript refers to V.0.8 of the protocol (7 November 2022). The trial is registered with the ISRCTN (ISRCTN11449333). The first participant was recruited on 18 June 2022.The main output of this feasibility trial will be the knowledge gained to help inform the development of a large multicentre RCT to evaluate the clinical and cost effectiveness of the use of live streaming to aid EMS dispatch for trauma incidents.Trial registration numberISRCTN11449333.

The SEE-IT Trial: emergency medical services Streaming Enabled Evaluation In Trauma: a feasibility randomised controlled trial

“…These comprised (i) an inner-city sub-study in an ambulance service already routinely using video livestreaming to explore the acceptability and feasibility of using video livestreaming in a more diverse population; and (ii) a staff wellbeing sub-study in an ambulance service not using video livestreaming to provide comparison to the trial staff. The full trial protocol was published once no further protocol changes were required [ 17 ]. Previous versions of the trial protocol can be found on the NIHR website, including a log of amendments [ 18 ].…”

“…A full list of sites is provided in the trial protocol [ 17 ]. The observational inner-city sub-study was conducted in London Ambulance Service NHS Trust (LAS, including London’s Air Ambulance Charity, LAA), and the staff wellbeing sub-study was in East of England NHS Trust (EEAST).…”

“…This included calls where HEMS or CCP(s) were required at the scene of trauma incidents within trial observation shifts, but where the code to indicate eligibility of the incident for the trial had not been entered into the CAD by the HEMS dispatcher/CCD; (iv) request for further ambulance resources from scene: requests for enhanced dispatch resources (CCP and/or HEMS) from the scene were recorded by the Research Paramedics observing all trial shifts. The outcomes and their data collection and analysis are described in the trial protocol [ 17 ].…”

Intra- and Extra-Hospitalization Monitoring of Vital Signs—Two Sides of the Same Coin: Perspectives from LIMS and Greenline-HT Study Operators

“…Telemedicine can be categorized, on one hand, by implemented activities (i.e., televisits, teleconsultations, and tele-healthcare cooperation), and on the other, by activity purposes, which can be summarized as follows: Remote monitoring: A variety of medical-health activities with the purpose of monitoring a patient’s health status, via the implementation of routine medical tests, the communication of medical results to healthcare professionals, and the potential transmission of automated responses [ 7 , 8 , 9 ]. The collection and sharing of clinical data, which aims to disseminate clinical information that is less sensitive to time between healthcare professionals and/or between doctors and patients, and which currently often involves a delay between the transmission, the receipt of, and the response to the content that was shared [ 10 , 11 ]. Interactive synchronous telemedicine, which includes practices involving real-time communication between doctors and patients, which may or may not involve the activity of data sharing [ 12 , 13 ].…”

“…The collection and sharing of clinical data, which aims to disseminate clinical information that is less sensitive to time between healthcare professionals and/or between doctors and patients, and which currently often involves a delay between the transmission, the receipt of, and the response to the content that was shared [ 10 , 11 ].…”