The Pre-POCT-Non-Conveyance Trial: Prehospital Point-of-Care Testing to Support Non-Conveyance Decisions
Prehospital Point-of-Care Testing to Support Decision-Making in Alternative and Non-Conveyance Pathways: A Matched Parallel Cluster-Randomised Trial. The Pre-POCT-Non-Conveyance Trial
Central Denmark Region
1,500 participants
May 26, 2026
INTERVENTIONAL
Conditions
Summary
The goal of this clinical trial is to evaluate whether rapid blood tests performed in the ambulance can be implemented in routine prehospital assessment of adults who are initially considered for transport 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 considered for hospital transport. The main question is whether prehospital POCT can be performed, documented, and made available before the final conveyance decision in routine ambulance-based assessment. The study will also examine whether access to POCT is associated with a higher proportion of patients remaining at home rather than being transported to hospital. Safety outcomes will include hospital admission within 24 hours among non-conveyed patients, short-stay hospitalization, intensive care unit (ICU) admission, and 30-day mortality. This study will evaluate the implementation of POCT-supported decision-making in prehospital care and explore whether it may increase non-conveyance without compromising patient safety.
Eligibility
Inclusion Criteria6
- Adults aged ≥18 years
- Emergency call or general practitioner-commissioned ambulance dispatch following telephone triage only, including video streaming triage, resulting in ambulance dispatch
- Initial on-scene assessments performed by the ambulance crew
- Patients initially considered for hospital conveyance based on clinical assessment
- Following telemedical consultation with an Emergency Medical Dispatch Centre (EMDC) physician, deemed eligible for point-of-care blood testing (POCT)
- Hemodynamically and clinically stable according to predefined operational stability criteria (including Glasgow Coma Scale, blood pressure, oxygen saturation, and heart rate), with final eligibility determined by the EMDC physician based on overall clinical assessment and the patient's baseline status
Exclusion Criteria6
- Non-emergency calls (e.g., interfacility transport or scheduled patient transport)
- General practitioner-commissioned ambulance dispatches where the patient has been physically assessed by a general practitioner or another physician before ambulance arrival
- Immediate need for emergency transport to hospital as determined by clinical assessment
- Persistent unstable vital signs outside predefined operational thresholds, except for known chronic baseline deviations (e.g., reduced oxygen saturation in patients with chronic obstructive pulmonary disease or chronic tachyarrhythmia in atrial fibrillation)
- Inability to obtain venous or capillary blood samples
- Prior participation in the study within 30 days (to ensure complete outcome follow-up)
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Interventions
On-scene biochemical testing performed using portable point-of-care devices. non-conveyance.
Locations(1)
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NCT07503470