救急車からのビデオストリーミングが急性脳卒中患者の人生を変える可能性(Video streaming from ambulance can be life-changing for acute stroke patients)

2024-10-03 チャルマース工科大学

<関連情報>

• https://news.cision.com/chalmers/r/video-streaming-from-ambulance-can-be-life-changing-for-acute-stroke-patients,c4046605
• https://bmcmedinformdecismak.biomedcentral.com/articles/10.1186/s12911-024-02539-7

病院前脳卒中診察のビデオサポート:病院前シミュレーションから得られたシステム設計と臨床導入への示唆 Video support for prehospital stroke consultation: implications for system design and clinical implementation from prehospital simulations

Stefan Candefjord,Magnus Andersson Hagiwara,Bengt Arne Sjöqvist,Jan-Erik Karlsson,Annika Nordanstig,Lars Rosengren & Hanna Maurin Söderholm
BMC Medical Informatics and Decision Making  Published:29 May 2024
DOI:https://doi.org/10.1186/s12911-024-02539-7

Abstract

Background
Video consultations between hospital-based neurologists and Emergency Medical Services (EMS) have potential to increase precision of decisions regarding stroke patient assessment, management and transport. In this study we explored the use of real-time video streaming for neurologist–EMS consultation from the ambulance, using highly realistic full-scale prehospital simulations including role-play between on-scene EMS teams, simulated patients (actors), and neurologists specialized in stroke and reperfusion located at the remote regional stroke center.

Methods
Video streams from three angles were used for collaborative assessment of stroke using the National Institutes of Health Stroke Scale (NIHSS) to assess symptoms affecting patient’s legs, arms, language, and facial expressions. The aim of the assessment was to determine appropriate management and transport destination based on the combination of geographical location and severity of stroke symptoms. Two realistic patient scenarios were created, with severe and moderate stroke symptoms, respectively. Each scenario was simulated using a neurologist acting as stroke patient and an ambulance team performing patient assessment. Four ambulance teams with two nurses each all performed both scenarios, for a total of eight cases. All scenarios were video recorded using handheld and fixed cameras. The audio from the video consultations was transcribed. Each team participated in a semi-structured interview, and neurologists and actors were also interviewed. Interviews were audio recorded and transcribed.

Results
Analysis of video-recordings and post-interviews (n = 7) show a more thorough prehospital patient assessment, but longer total on-scene time, compared to a baseline scenario not using video consultation. Both ambulance nurses and neurologists deem that video consultation has potential to provide improved precision of assessment of stroke patients. Interviews verify the system design effectiveness and suggest minor modifications.

Conclusions
The results indicate potential patient benefit based on a more effective assessment of the patient’s condition, which could lead to increased precision in decisions and more patients receiving optimal care. The findings outline requirements for pilot implementation and future clinical tests.