The goal of this clinical trial is to determine whether rapid blood tests performed in the ambulance can help identify adults who can safely remain at home instead of being transported to hospital. Ambulance clinicians frequently assess adults who are transported to hospital but discharged shortly after arrival without requiring advanced diagnostic testing or treatment. In this study, researchers will examine whether adding rapid point-of-care blood testing (POCT) at the scene supports ambulance clinicians and Emergency Medical Dispatch Centre (EMDC) physicians in making more informed decisions about hospital conveyance. POCT provides rapid measurements of biomarkers including infection markers, electrolytes, kidney function, blood counts, and total carbon dioxide (a proxy measure related to acid-base status). Ten ambulance clusters will participate in a matched, cluster-randomized design. Half will provide standard care, and half will have access to POCT following consultation with an EMDC physician in patients who would otherwise be transported. The main question is whether access to POCT increases the proportion of patients who remain at home rather than being transported to hospital. Safety outcomes will include hospital admission within 24 hours among non-conveyed patients, short-stay hospitalization (defined as admission \<6 hours without advanced interventions), intensive care unit (ICU) admission, and 30-day mortality. This study will evaluate whether POCT-supported decision-making can increase non-conveyance without compromising patient safety.
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Non-conveyance rate
Timeframe: Day 1 (at completion of on-scene assessment)