Study of Ambulance-Based Mobile Health Support for Children in Emergencies in Low-Resource Areas

What this Trial Is About

Researchers are evaluating the use of ambulance-based telemedicine to improve medical decisions and health outcomes for acutely ill children in low-resource settings. This study is being conducted in Karachi, Pakistan, where investigators will compare the care of children transported by ambulances that either receive telemedicine support from remote pediatric emergency physicians or receive standard paramedic care. The goal is to assess whether real-time audio-video consultation during ambulance transport can enhance emergency care quality and patient outcomes. The study involves 60 ambulances randomly assigned to either the intervention group, which receives telemedicine support via a mobile health system, or the control group, which receives standard ambulance care without telemedicine. The telemedicine setup includes devices such as IP phones, 360-degree cameras, headsets, tablets for data entry, and 4G internet connectivity to enable live communication between emergency medical technicians, patients, caretakers, and telemedicine physicians. The intervention is delivered during ambulance transport, with data collected at ambulance pickup, hospital drop-off, and emergency department triage. Participants include children aged 0 to 14 years transported by ambulance for at least 20 minutes and accompanied by a parent or guardian who can consent. Emergency medical technicians and telemedicine physicians involved in the study will receive training and consent individually. Data collected include Pediatric Early Warning Signs PEWS scores at multiple points, telemedicine call completion rates, satisfaction surveys, and patient outcomes up to 72 hours after emergency department arrival. The study will monitor and compare changes in PEWS scores to evaluate the impact of telemedicine support during transport.

Feasibility and Efficacy of Ambulance-Based m-Health for Pediatric Emergencies (FEAMER) Trial