Tele-emergency physician systems in German emergency medical services: a nationwide survey

Abstract

Background and objectives: Only little data about the status of implementation and development of tele-emergency physician systems in German emergency medical services (EMS) have been reported yet. We present data of a nationwide survey of tele-emergency physician systems. Materials and method: In an online survey, active German EMS staff of all professions were interviewed regarding the availability and design of a tele-emergency physician system, existing standard operating procedures (SOP) for defined emergency scenarios, and their personal opinion on the topic of tele-emergency physicians. Results: In all, 1023 participants from 77.1% (n = 299) of all German districts completed the survey: 90.3% (n = 270) of the districts had no tele-emergency physician system, while 9.3% (n = 29) had systems that were at least partially operating. System design is heterogeneous. SOP for EMS personnel differ considerably even within the states and between systems with or without tele-emergency physicians. Systems with tele-emergency physicians have a higher percentage of SOP and paramedics perform several procedures more often. Intravenous analgesia by paramedics is not provided by 0.8% vs. 8.9% (n = 1 vs. n = 76) of the respondents, while 3.1% vs. 23.1% (n = 4 vs. n = 198) do not administer acetylsalicylic acid in case of acute coronary syndrome without ST elevation. Personal opinions on the topic tele-emergency physician differed significantly between districts with and without an operating tele-emergency physician system. Conclusion: Less than one-tenth of the German EMS districts have an operating tele-emergency physician system and the design of available systems is heterogeneous. This also applies for standard operating procedures. Therefore, it can be concluded that there might be relevant differences in quality of emergency care by EMS nationwide.