Evidence map›Paper›PMID 39382769›Full record

ArticleCJEM2025

Evaluating the impact of a specialized and centralized online medical consultation system for paramedics: pilot study.

Kevin Guo, Michael Austin, Benjamin De Mendonca, Zachary Cantor, Megan Wall, Catherine Cox, Joe Ferguson, Christian Vaillancourt

Abstract read
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In one paragraph

Article in CJEM, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Kevin GuoDepartment of Emergency Medicine, Ottawa Hospital, University of Ottawa, Civic Campus, 1053 Carling Avenue, Ottawa, ON, K1Y 4E9, Canada. kguo@toh.ca.ORCID 0000-0002-3946-6137
Michael AustinDepartment of Emergency Medicine, Ottawa Hospital, University of Ottawa, Civic Campus, 1053 Carling Avenue, Ottawa, ON, K1Y 4E9, Canada.
Benjamin De MendoncaRegional Paramedic Program for Eastern Ontario, Ottawa, ON, Canada.
Zachary CantorRegional Paramedic Program for Eastern Ontario, Ottawa, ON, Canada.
Megan WallRegional Paramedic Program for Eastern Ontario, Ottawa, ON, Canada.
Catherine CoxRegional Paramedic Program for Eastern Ontario, Ottawa, ON, Canada.
Joe FergusonRegional Paramedic Program for Eastern Ontario, Ottawa, ON, Canada.
Christian VaillancourtDepartment of Emergency Medicine, Ottawa Hospital, University of Ottawa, Civic Campus, 1053 Carling Avenue, Ottawa, ON, K1Y 4E9, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThere are many limitations to utilizing on-duty emergency department (ED) physicians as Base Hospital Physicians for paramedic telephone consultations. We aimed to examine the impact of a specialized and centralized Online Medical Consultation program for paramedic consultations on system-relevant performance.

methodsThis is a before-after study with concurrent control using health record review of audio recordings over a 6-month period before and after implementation of the Online Medical Consultation program. The primary outcome was the duration of paramedic consultation calls. The secondary outcomes included number of calls with orders that contradicted existing medical directives, number of calls with orders outside of paramedic scope of practice, number of calls with Base Hospital Physician requiring clarification on medical directives, and number of calls with Base Hospital Physician interrupting the paramedic during the call.

resultsWe included 220 consultation calls. The patients' mean age was 54.5 years. Most consultation calls (70.5%) were for mandatory consultations and 22.7% were voluntary. Most consultations were related to cardiac arrest (43.6%), combative patients (15.0%), and analgesia (13.6%). Before-after comparisons for total call duration showed that mean call duration decreased in Ottawa from 4:28 to 4:05 min (p = 0.77) and decreased in Kingston from 4:50 to 4:13 min (p = 0.49). There were no significant differences in our secondary outcomes.

conclusionsThe Online Medical Consultation program was implemented and removed the responsibility of responding to online medical consultations for on-duty emergency physicians in Ottawa. The total call duration was not significantly different between groups. Additional time intervals and adherence to protocol benefits were also not statistically significant due to low baseline incidence.

Indexed as

Allied Health PersonnelEmergency Medical ServicesEmergency Service, HospitalReferral and ConsultationRemote ConsultationAdultFemaleHumansMaleMiddle AgedParamedicsPilot ProjectsRetrospective StudiesBase hospital physicianClinical adviceMedical controlParamedicPrehospitalTeleconsultation

Identifiers

PMID39382769

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.