Improved triage and emergency care for children reduces inpatient mortality in a resource-constrained setting.
Elizabeth Molyneux, Shafique Ahmad, Ann Robertson
https://pubmed.ncbi.nlm.nih.gov/16628305Actively Recruiting
Phase Not Applicable
Age: 1Minute - 14Years
All Genders
Healthy Volunteers
ID07027813
Feasibility and Efficacy of Ambulance-Based m-Health for Pediatric Emergencies in Low Resource Settings (FEAMER) Trial
Led by Weill Medical College of Cornell University · Updated on 2026-01-07
900
Participants Needed
3
Research Sites
26 weeks
Total Duration
On this page
Sponsors
W
Weill Medical College of Cornell University
Lead Sponsor
E
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
Collaborating Sponsor
AI-Summary
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.
CONDITIONS
Brief Title
Feasibility and Efficacy of Ambulance-Based m-Health for Pediatric Emergencies (FEAMER) Trial
Who Can Participate
Age: 1Minute - 14Years
All Genders
Healthy Volunteers
Eligibility Criteria
You may qualify if you...
- Children aged 0 to 14 years
- Children transported by an SIEHS ambulance with transport time of 20 minutes or more
- Children presenting to the ChildLife Emergency Department with a parent or guardian present in the ambulance to provide consent
- Children classified as Charlie, Delta, or Echo on the Medical Priority Dispatch System
- Emergency medical technicians currently employed by the SIEHS EMS service
- Telemedicine physicians currently employed by the CLF Telemedicine services
You will not qualify if you...
- Children transported without an adult parent or guardian
- Emergency medical technicians who refuse to participate or consent to the study
- Telemedicine physicians who refuse to participate or consent to the study
AI-Screening
AI-Powered Screening
Complete this quick 3-step screening to check your eligibility
1
2
3
Your Study Journey
Screening
Duration - 2 to 4 weeks
Participants are screened for eligibility to participate in the trial.
1 visit (in-person) during ambulance transport
Treatment
Duration - During ambulance transport lasting 20 minutes or more
Participants are transported by ambulance with or without telemedicine support from physicians during the ride, receiving emergency care and monitoring.
1 ambulance transport visit
Follow-up
Duration - Up to 72 hours after emergency department visit
Participants are monitored in the emergency department and contacted 72 hours after the visit to assess outcomes and offer withdrawal from the study.
1 emergency department visit and 1 follow-up phone call
Trial Site Locations
Total: 3 locations
1
Aga Khan University Hospital
Karachi, Sindh, Pakistan, 74800
Active, Not Recruiting
2
ChildLife Foundation
Karachi, Sindh, Pakistan
Actively Recruiting
3
Sindh Integrated Emergency and Health Services (SIEHS)
Karachi, Sindh, Pakistan
Actively Recruiting
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Research Team
J
Junaid A. Razzak, MD,PhD,FACEP
S
Sheza Hassan, MBBS
How is the study designed?
Study Type
INTERVENTIONAL
Masking
NONE
Allocation
RANDOMIZED
Model
PARALLEL
Primary Purpose
TREATMENT
Number of Arms
4
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