Telemedicine For Trauma Research Articles

Interest in Improving Access to Pediatric Trauma Care Through Telemedicine.

Despite improved outcomes at pediatric trauma centers (PTC), 90% of injured children are not treated at PTCs. Telemedicine may play a role in ensuring patients are transferred to the appropriate level of care. We aimed to determine the level of interest in trauma telemedicine with our PTC among referring facilities. A survey was conducted with the trauma program directors of 45 hospitals in Utah, which consisted of four multiple choice questions designed to determine interest in pediatric trauma telemedicine support, projected frequency of use, anticipated uses of telemedicine, and perceived barriers to implementation. Forty-one directors (91%) responded. 88% of directors were interested in developing a pediatric trauma telemedicine network. 20% estimated their center would use telemedicine more than once a week, 17% once a week, 24% once a month, and 37% a few times a year. The most frequently cited uses of a telemedicine program were triage/transfer decisions and provider support. Inadequate volume and insufficient funding were the most common perceived barriers. These data show there is a strong interest amongst hospitals in our state in pediatric trauma telemedicine. Inadequate volume to warrant a program and insufficient facility funding remain concerns for development of a program.

Pediatric trauma telemedicine in a rural state: Lessons learned from a 1-year experience

BackgroundPrevious research from our center has shown that 27% of the pediatric trauma transfers from referring facilities are potentially preventable. Our hospital is the only level 1 pediatric trauma center (PTC) in our state, and we are developing a pediatric trauma telehealth network to help keep certain injured children closer to home. We instituted a pediatric trauma telehealth program with a partnering community-based hospital in our state and aim to report our experience over the first year. MethodsAll pediatric trauma patients that presented to our partnering hospital from January 2019 to February 2020 were reviewed. Disposition was: a) telehealth consultation, b) admission to the children's unit without a telehealth consultation per our head trauma protocol, or c) transfer without telehealth consultation. Data on demographics, hospital course, and disposition were collected via chart review. ResultsEight patients underwent telehealth consults and another 8 patients were admitted to the partnering hospital's children's unit based on the head trauma protocol without a telehealth consult. Patient's ages ranged from 7 months to 15 years. Of the patients that underwent telehealth consult, 7 presented with a head injury and 1 presented with a rib fracture/small pneumothorax. The patient with a pneumothorax was observed for 6 h and discharged home after a repeat chest x-ray was stable. All 15 patients with head injuries were observed and discharged from either the emergency department or children's unit after passing concussion testing. No patients required transfer to our PTC after observation, and none were readmitted. Fifty-six patients were transferred without telehealth consultation, and 3 of these patients could potentially have avoided transfer with a telehealth consultation. ConclusionsTelehealth in pediatric trauma can be a safe mechanism for preventing the transfer of patients that can be safely observed at a partnering hospital. From a facility that transfers an average of 30 trauma patients per year to our hospital, this program prevented 16 such transfers. Development of a head trauma protocol in collaboration with a pediatric neurosurgeon leads to an unexpected number of patients being admitted to the partnering hospital for observation without utilization of a telehealth consultation. Type of studyRetrospective study. Level of evidenceIII

The Use of Telemedicine Decreases Unnecessary Hand Trauma Transfers.

Purpose: The Arkansas Hand Trauma Telemedicine Program (AHTTP) is a novel telemedicine system that was developed in 2014 within a rural state to address the growing need of access to hand trauma care with one trauma center that cares for mangling hand injuries. The purpose is to compare transfers for hand injuries prior to and after the implementation of this system. Methods: The hospital institutional database was queried for all transfers to a level 1 medical center in the state from 2012 to 2015, allowing the comparison of data prior to and after the institution of the AHTTP. Patient disposition from the emergency department was categorized to evaluate the impact of AHTTP. Distance, mode of transport, and transport cost were assessed. Findings: There were 202 transfers for the treatment of isolated hand trauma (92 from 2012 to 2013 and 110 from 2014 to 2015). Prior to the institution of AHTTP, transfer patients were admitted 47.8% of the time compared with 68.2% of the time after the development of the program (P = .02). The approximate cost of transport for patients who were discharged home directly from the emergency department was 38.5% (US $47,233) of the total costs for the 2012-2013 period and was 21.4% (US $34,017) of the costs for the 2014-2015 period (P < .0001). Conclusions: There was a statistically significant decrease in the number of unnecessary transfers and transportation costs after the telemedicine program was started. The implementation of AHTTP in a rural state reduced health care costs and improved the efficiency of hand specialty care.

Telemedicine for Trauma and Emergency: the eICU

The purpose of this study was to describe the current use of telemedicine in the intensive care units (ICUs), particularly as it relates to trauma and emergency. Telemedicine in the ICU has been validated through several large before-after studies with positive effects on mortality, morbidity, and length of stay. New research agendas looking at how best to utilize it and to prove efficacy are required. The USA and most of the Western world face several major healthcare challenges including an aging population, lack of critical care physicians, and importantly a lack of financial resources. Telemedicine in the ICU makes possible to use intensivists from major medical centers to provide critical care services in small hospitals in remote areas that otherwise will not be able to care for their sick and injured patients.

Telemedicine for Trauma and Emergency Management: an Overview

Purpose of Review This review focuses on the evolution of telemedicine programs on both national and international levels as it pertains to trauma and emergency medical care.

Rural Trauma Telemedicine

Telemedicine is the ability to provide remote health care to patients with the use of a consultant and 2-way interactive technology and telecommunication. Traumatic injuries occurring in rural areas frequently carry a greater risk of mortality than those same injuries occurring in the urban settings. The purpose of this article was to increase practitioner awareness of the potential for improved outcomes as a result of the use of telemedicine in rural trauma care. The use of trauma telemedicine will help decrease the overall mortality and morbidity, length of stay at the urban trauma centers, patient care cost, and transfer time.

Telemedicine for Trauma is Promising

Telemedicine (TM) allows consultants to have real-time audio-video access to rural and remote healthcare facilities. In this study, trauma surgeons