• Scand J Trauma Resus · Oct 2022

    Randomized Controlled Trial

    Photography tele-transmission by regular ambulance staff for the management of mild traumatic injury: the NiCEPHORE randomised-controlled trial.

    • E Magimel-Pelonnier, N Marjanovic, R Couvreur, B Drugeon, O Mimoz, and J Guenezan.
    • Emergency Department and Pre-Hospital Care, University Hospital of Poitiers, Service des Urgences, CHU de Poitiers, 2 rue de la Mileterie, 86000, Poitiers, France. edouard.magimel-pelonnier@chu-poitiers.fr.
    • Scand J Trauma Resus. 2022 Oct 14; 30 (1): 53.

    BackgroundHandling emergency calls in French emergency medical call centres (EMCCs) can be challenging considering the frequent lack of relevant information. Tele-transmission device use in regular ambulances seems like a good solution to provide the EMCC physician with a more accurate assessment of the scene, particularly for mild traumatic injury (MTI). We measured the impact of ambulance staff tele-transmitted photography on prehospital dispatching optimisation for patients calling the EMCC with MTI.MethodsWe conducted a prospective, single-centre, randomised-controlled trial comparing two groups of patients calling the EMCC with MTI who were or were not allocated to photography tele-transmission by ambulance staff. The primary outcome was the proportion of patients referred away from the nearest hospital (left at home for outpatient care; referred to a higher-level hospital; handled by a medical intensive care ambulance for advanced pre-hospital care) used as a marker of better orientation.ResultsBetween 29 April 2019 and 21 July 2020, 165 patients were randomised and 152 analysed. Photography tele-transmission resulted in better patient dispatching (24/73 [33%] patients in the intervention group vs 9/79 [11%] patients in the control group, OR 3.80 [1.63-8.90]; p = 0.03), without increasing the proportion of patients initially left at home for outpatient care and visiting an ED within 10 days for secondary trauma-related care (1/14 [7%] vs 1/4 [25%], OR 0.25 [0.01-24.1]; p = 0.41). The proportion of patients unnecessarily referred to an ED was 7% [4/59 patients] in the intervention group vs 16% [12/75 patients] in the control group (OR 0.38 [0.09-1.36]; p = 0.10).ConclusionPhotography tele-transmission by regular ambulance staff could improve the dispatching of patients calling French EMCCs with MTI. Trial registration The study is registered with Clinicaltrials.gov (NCT04034797).© 2022. The Author(s).

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