The evidence behind GoodSAM

This retrospective study examined whether paramedic led video telecommunication using the GoodSAM platform increased rates of pre-arrival CPR within the San Antonio Fire Department EMS system between July 2021 and February 2022.

Among 779 eligible OHCA cases, pre-arrival CPR was significantly more common when video telecommunication was used compared with standard audio dispatch (62% vs 46%; absolute difference 16.2%, 95% CI 4.6-27.9; p=0.008). Video use was also associated with family members more frequently initiating CPR. These findings suggest dispatch video telemedicine can improve early bystander CPR.

This study used GoodSAM as a virtual ED video tool for 3 months and demonstrated in the 867 video consultations the system:

• Prevented 58% of ambulance transfers to ED.
• 97% of staff and those rural practitioners referring through the system found it "very good" or "excellent".
• 43% of those advised to attend ED were then admitted.
• 21.3% of patients were referred directly to the specialist service within the hospital.

This study analysed 838 emergency GoodSAM Instant-On-Scene Videos. Key findings:

• 838 emergency videos
• GoodSAM video changed assessment of the patient's condition in 51.1% of calls - 12.9% more critical, 38.2% less critical
• GoodSAM video altered emergency response in 27.5% of cases
• Quality of care (e.g. CPR or airway) improved in 28.4% of calls with GoodSAM Video
• 97.3% of callers felt live video should be implemented.

CPR was provided with live video in 51 OHCA. Video guided CPR improved CPR quality:

• Hand position (incorrect in 36 cases, improving in 23 (60.5% OR 5.8)
• Compression rate (incorrect in 35 cases, improved in 26 (75% OR 7.7)
• Compression depth (incorrect in 54 cases, improved in 32 (58% OR 7.1)

This seminal paper demonstrated the ease of use, reliability, patient flow and governance processes that make GoodSAM Instant-On-Scene video ideal for HEMS service deployment.

This study by the team at Ambulance Victoria completed 738 video consultations for non-urgent mental health concerns. They demonstrated GoodSAM video resulted in fewer emergency ambulance dispatches compared with voice-only triage with increased referral to alternative/more appropriate services.

This report evaluated GoodSAM video in North West Ambulance Service 111 Centre

Key Findings:

• In 93% of calls, an outcome was reached more quickly with GoodSAM video.
• 17% of calls were upgraded.
• 24% of calls were downgraded.
• 96% of dispatchers said it increased their confidence in clinical decision making.
• In 62% of cases it prevented the onward need for a face to face consultation.
• And >97% found the GoodSAM system easy to use.
• Call times were reduced from 15 minutes to 6 minutes.

Key Findings:

This study compared video and telephone triage of 617 paediatric patients with respiratory tract infections with fewer video-triaged patients needing assessment at hospital (39% vs 46% p=0.07). The technique was highly feasible and acceptable with no adverse events registered.

This study randomised 1059 calls to virtual or in-person response. There were significant improvements across all measures with GoodSAM Video response:

• Victim wait times
• Odds of Arrest and Charges
• Perception of procedural justice
• Satisfaction
• Trust
• Confidence in Police

With no evidence of adverse effects.

This study of 560 domestic violence victims found that, compared to standard follow up, GoodSAM video resulted in:

• 656 times faster response to victims (3mins vs 1969 mins)
• Higher victim satisfaction (89% vs 78%)
• A 50% higher arrest rate (24% vs 16%)
• Improves Trust and confidence in the police

This population based observational cohort study of 9196 out-of-hospital cardiac arrests found that 1158 had a smartphone activated responder attend (564 before EMS arrival and 594 after). The risk-adjusted odds ratio of patient survival to hospital in those that had a smartphone activated responder before EMS arrival was 1.37 i.e. a 37% increase in survival.

Key findings:

• Being attended by a GoodSAM Responder increased Odds ratio for survival to hospital discharge by
• 3.15 in East Midlands and
• 3.19 in London

* Reported acceptance rates were low (1-5%) however, this is 2016 data and responder density and acceptance is considerably higher now (> 15%).

Brian Haskins

This web based survey of 1985 responders found that 38% accepted alerts, 27% arrived on scene and 14% provided patient care. One responder screened positive for PTSD attributing events at and outside of work with also the smartphone alert contributing.

This case study by Neil Churchill OBE describes the deployment of GoodSAM in partnership with NHSE and the Royal Voluntary Service during Covid to recruit and manage 800,000 NHS Volunteers. This was the first scaled roll out of micro-volunteering.

This is a comprehensive report of micro-volunteering during the Covid Pandemic. It should be noted that GoodSAM was working in partnership with NHSE and RVS and hence the actual specification / delivery of some aspects were at their direction.

This is a comprehensive report of the NHS Volunteer programme powered by GoodSAM during the pandemic.