# Feasibility and Efficacy of Ambulance-Based mhealth for Pediatric Emergencies (FEAMER) Trial

> **NIH NIH R21** · WEILL MEDICAL COLL OF CORNELL UNIV · 2022 · $204,600

## Abstract

Project Summary
Of the 16000 children who die every day, 7000 die because of five acute illnesses – pneumonia, diarrhea,
injuries, meningitis, and malaria – largely in in low- and middle-income countries (LMICs). Appropriate and
timely acute and emergency care of these children can reduce such deaths by about half. Modern emergency
care systems provide care through a “chain of survival” consisting of on-scene care, emergency medical services
(EMS) for transportation, and hospital emergency departments. Care and triage decisions by healthcare
providers during transportation play a critical role in the eventual outcome of patients from many acute
illnesses and are, therefore, considered an essential service in most high-income countries (HICs). EMS with
well-trained staff, especially in the care of an acutely ill child, is rarely found in LMICs. There is a critical need
– globally, but particularly in LMICs – for solutions that address the expertise/experience gap during the most
critical minutes and hours of a child's transport to a fixed emergency care facility. Such solutions can
contribute to potentially saving thousands of children every year. Currently, no information exists to prove the
feasibility and utility of mobile health technology to guide care during transport of acutely ill children. The
purpose of the study is first to assess the feasibility of implementing an ambulance-based teleconsultation
(ABT) process (R21) and, if feasible, carry out a clinical trial to confirm the efficacy of the approach on the
short-term clinical outcomes (R33) in Karachi, Pakistan.
Our specific aims are SA1: To assess the acceptability of ABT for the emergency care of acutely ill
children. SA2: To determine the feasibility of carrying out a pilot cluster-randomized trial on the impact of
ABT on the Pediatric Early Warning Score (PEWS). SA3: To determine the feasibility of carrying out a cluster-
randomized trial on the impact of ABT on the Pediatric Early Warning Score (PEWS). If found feasible, we will
conduct an efficacy trial with the following R33 specific aims: Specific Aim 4: To test the efficacy of ABT by
measuring a change in the PEWS of acutely ill children from the scene of injury/illness to the pediatric
emergency department (PEM) using a cluster-randomized design Specific Aim 5: To develop the capacity of
local partners in m-health research capacity.

## Key facts

- **NIH application ID:** 10269089
- **Project number:** 1R21HD103049-01A1
- **Recipient organization:** WEILL MEDICAL COLL OF CORNELL UNIV
- **Principal Investigator:** Junaid Abdul Razzak
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $204,600
- **Award type:** 1
- **Project period:** 2022-02-16 → 2027-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10269089

## Citation

> US National Institutes of Health, RePORTER application 10269089, Feasibility and Efficacy of Ambulance-Based mhealth for Pediatric Emergencies (FEAMER) Trial (1R21HD103049-01A1). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10269089. Licensed CC0.

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