Ambulance-based mobile telemedicine for children with emergencies
Feasibility and Efficacy of Ambulance-Based m-Health for Pediatric Emergencies in Low Resource Settings (FEAMER) Trial
This will test whether linking ambulances to remote pediatric emergency doctors by audio-video during transport improves care and outcomes for critically ill children in Karachi.
Quick facts
| Phase | Not applicable |
|---|---|
| Study type | Interventional |
| Enrollment | 900 (estimated) |
| Ages | 1 Minute to 14 Years |
| Sex | All |
| Sponsor | Weill Medical College of Cornell University Academic / other |
| Locations | 3 sites (Karachi, Sindh and 2 other locations) |
| Trial ID | NCT07027813 on ClinicalTrials.gov |
What this trial studies
In Karachi, Pakistan, researchers will compare ambulance transports that include a live audio‑video telemedicine consult with a remote pediatric emergency physician to transports that receive standard paramedic care. They will enroll children aged 0–14 who are transported by SIEHS ambulances with transport times of 20 minutes or more and who are triaged as high acuity (Charlie/Delta/Echo). Clinical data will be collected at pickup, hospital drop‑off, and during emergency department triage to compare prehospital decisions, interventions, and short‑term outcomes. The intervention uses a simple mHealth device to support EMTs during transport and requires a parent or guardian in the ambulance to provide consent.
Who should consider this trial
Good fit: Children aged 0–14 transported by participating SIEHS ambulances to the ChildLife Emergency Department with transport times ≥20 minutes, triaged as Charlie/Delta/Echo, and with a parent or guardian present to consent.
Not a fit: Children with transport times under 20 minutes, those transported without a parent or guardian to consent, or low-acuity patients are unlikely to benefit from the telemedicine intervention.
Why it matters
Potential benefit: If successful, this could improve prehospital decision-making and reduce complications and deaths among critically ill children transported in low-resource settings.
How similar studies have performed: Telemedicine support for EMS has shown feasibility and improved decision-making in some high-income settings, but ambulance-based pediatric telemedicine in low-resource LMIC settings remains largely novel and unproven.
Eligibility criteria
Show full inclusion / exclusion criteria
CHILDREN Inclusion criteria: * Age 0-14 years * Children transported by an SIEHS ambulance with a transport time of ≥20 minutes * Children presenting to the ChildLife Emergency Department with a parent/ guardian present in the ambulance to consent * Children classified as "Charlie, Delta, Echo" on the Medical Priority Dispatch System Exclusion Criteria: • Children transported without an adult parent or guardian EMERGENCY MEDICAL TECHNICIANS (EMTs) Inclusion Criteria: • EMTs currently employed by the SIEHS EMS service. Exclusion Criteria: • EMTs who refuse to participate or consent to the study. TELEMEDICINE PHYSICIANS (TMPs) Inclusion Criteria: • TMPs currently employed by the CLF Telemedicine services. Exclusion Criteria: • TMPs who refuse to participate or consent to the study.
Where this trial is running
Karachi, Sindh and 2 other locations
- Aga Khan University Hospital — Karachi, Sindh, Pakistan (Active_not_recruiting)
- ChildLife Foundation — Karachi, Sindh, Pakistan (Recruiting)
- Sindh Integrated Emergency and Health Services (SIEHS) — Karachi, Sindh, Pakistan (Recruiting)
Study contacts
- Principal investigator: Junaid Razzak, MD,PhD,FACEP — Weill Cornell School of Medicine, NY
- Study coordinator: Junaid A. Razzak, MD,PhD,FACEP
- Email: jur9123@med.cornell.edu
- Phone: +1 (443) 722-9239
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.