{
  "abstract": "Introduction Globally, half of all 6.2 million deaths in children are caused by acute illnesses which can be prevented if diagnosed and treated in time. We hypothesise that long elapsed travel time and delay in care can be tackled using telemedicine. The objective of this study is to determine the acceptability of linking ambulances that transport acutely ill children to a remote paediatric emergency physician using a simple audiovisual device.Methods We conducted a qualitative study to determine the acceptability of ambulance-based teleconsultation for the emergency care of acutely ill children informed by the Theoretical Framework of Acceptability. We developed semistructured guides using this framework and conducted five interviews with telemedicine physicians (TMPs), 18 interviews with parents of children who recently needed an ambulance and four focused groups with emergency medical technicians (EMTs) who transport children.Results All participants were supportive of using the telemedicine consultation during ambulance transport in the proposed trial as they felt that having access to a video-based physician would offer prompt intervention, particularly for critically ill children in crowded cities and remote regions with scarce resources. Parents believed that ambulance-based telemedicine would enhance their trust in EMTs and reduce their stress. The concerns related to the intervention included parental reluctance in using video cameras due to privacy issues, doubts about doctors’ treatment reliability, risk of miscommunication and inadequate parental education. To address these challenges, the groups proposed solutions such as joint training for EMTs and TMPs, educating parents about intervention processes, improving telecommunication infrastructure and promoting public awareness.Conclusion Parents, EMTs and TMPs mutually agreed that the use of telemedicine during ambulance transport can be successfully implemented through proper training and is acceptable in our population. All participants agreed that this intervention holds great potential to improve the survival of critically ill children.",
  "authors": [
    {
      "affiliations": [
        "Department of Emergency Medicine, Weill Cornell Medicine and New York Presbytarian Hospital, New York, NY, USA"
      ],
      "name": "Sheza Hassan"
    },
    {
      "affiliations": [
        "University of Liverpool, Liverpool, UK"
      ],
      "name": "Kerry Woolfall"
    },
    {
      "affiliations": [
        "Center of Excellence for Trauma and Emergencies, The Aga Khan University, Karachi, Pakistan"
      ],
      "name": "Huba Atiq"
    },
    {
      "affiliations": [
        "Dean’s Office, The Aga Khan University, Karachi, Pakistan"
      ],
      "name": "Noreen Afzal"
    },
    {
      "affiliations": [
        "Center of Excellence for Trauma and Emergencies, The Aga Khan University, Karachi, Pakistan"
      ],
      "name": "Asma Altaf Hussain Merchant"
    },
    {
      "affiliations": [
        "Department of Emergency Medicine, Weill Cornell Medicine and New York Presbytarian Hospital, New York, NY, USA"
      ],
      "name": "Joanna Palasz"
    },
    {
      "affiliations": [
        "Department of Emergency Medicine, Weill Cornell Medicine and New York Presbytarian Hospital, New York, NY, USA"
      ],
      "name": "Walid Farooqi"
    },
    {
      "affiliations": [
        "Johns Hopkins University, Baltimore, Maryland, USA"
      ],
      "name": "Amyna Husain"
    },
    {
      "affiliations": [
        "Johns Hopkins University, Baltimore, Maryland, USA"
      ],
      "name": "Joseph Ali"
    },
    {
      "affiliations": [
        "ChildLife Foundation, Karachi, Pakistan"
      ],
      "name": "Irfan Habib"
    },
    {
      "affiliations": [
        "Sindh Integrated Emergency and Health Services, Karachi, Pakistan"
      ],
      "name": "Zeeshan Sheikh"
    },
    {
      "affiliations": [
        "Johns Hopkins University, Baltimore, Maryland, USA"
      ],
      "name": "Peter Doyle"
    },
    {
      "affiliations": [
        "Center of Excellence for Trauma and Emergencies, The Aga Khan University, Karachi, Pakistan"
      ],
      "name": "Adil Haider"
    },
    {
      "affiliations": [
        "Department of Emergency Medicine, Weill Cornell Medicine and New York Presbytarian Hospital, New York, NY, USA",
        "Center of Excellence for Trauma and Emergencies, The Aga Khan University, Karachi, Pakistan"
      ],
      "name": "Junaid Abdul Razzak"
    }
  ],
  "title": "Acceptability of ambulance-based telemedicine (ABT) for paediatric emergencies in Karachi, Pakistan",
  "uid": "7d942f8b-8b35-5cab-8e57-e7d407a8d543"
}