# Telemedicine for prehospital respiratory emergencies in a retrospective quality analysis

## TL;DR

This study shows that telemedicine can effectively manage prehospital respiratory emergencies with the help of specialized physicians.

## Contribution

The study provides empirical evidence on the effectiveness of tele-EMS systems in managing prehospital respiratory emergencies.

## Key findings

- Significant improvements in vital parameters were observed in patients managed by tele-EMS physicians.
- Only 0.63% of cases required an onsite physician due to patient instability.
- Tele-EMS physicians effectively managed respiratory emergencies until onsite help arrived.

## Abstract

Respiratory distress is a common reason for emergency medical service (EMS) physicians to be prehospitally involved. While the availability of telemedical EMS systems increases continuously, there is a gap in research regarding respiratory emergencies in the context of prehospital telemedicine. The aim of this study is to evaluate the quality of care provided in prehospital respiratory emergencies, managed through a tele-EMS system with a specialized EMS physician. Tele-EMS physician missions from 01/01/2019 to 12/31/2021 in Aachen, Germany, were analyzed. Adult patients presenting with dyspnea, peripheral oxygen saturation < 94%, respiratory rate > 19/min, or any combination of these factors, were included (n = 2234). Data were derived from mission protocols recorded by the attending tele-EMS physicians. Significant changes (p < 0.001) in vital parameters towards physiological ranges were observed. For the most common diagnoses, a significant improvement in patient condition was achieved with the use of appropriate medications. In 14 cases (0.63%), an onsite-EMS physician was requested. These cases were confirmed to involve unstable patients who required intervention of an onsite-EMS physician. The tele-EMS physician effectively bridged the time until arrival of the physician. Overall, the study demonstrated that respiratory emergencies were effectively managed using the tele-EMS physician system.