Ethics approval and consent to participate
The institutional ethics committee of the University Hospital Aachen has approved (EK 170/15) this trial on 25 November 2015. The ethics committee waived an informed consent for the first step of the trial, the randomisation and assignment to the treatment group, as it occurs before any patient contact to a physician and thus was not feasible. Written informed consent was required and provided at least at hospital admission by all patients who were followed up after randomisation and initial treatment with one of the two EMS.