Telemedicine For Trauma, Emergencies and Disaster Management
Telemedicine For Trauma, Emergencies and Disaster Management
Telemedicine For Trauma, Emergencies and Disaster Management
Trauma, Emergencies,
and Disaster
Management
Rifat Latifi, MD, FACS
Professor of Surgery, University
of Arizona, Tucson, Arizona
President and Founder
International Virtual e-Hospital
Foundation
Hyderabad, September 7, 2013
Disclosure
Current Telemedicine
Programs
Elective Telemedicine Program
Inter-hospital telemedicine and
telepresence and networkEmergency and Trauma
Digital ambulances and monitored
patient transport; EMS, Trauma
Deployable mobile telemedicine
systems- Disasters, Medical
Missions
Pre
Event
Chaotic situation,
difficult to create de
novo programs,
short term, ?? utility
Most importantly
During
the Event
Media
Effect,
resear
ch
paper
s
Post
Event
Vital Signs
Need for
telepresence:
Patients involved in
MVC in rural America
have twice the rate of
mortality with those in
an urban settings with
the same ISS
JAMA 2000;284
So what is
the all the
fuss about ?
Trauma Toll
16,000 X
365=5,800,000
Up to 50 million are
significantly injured
or disabled
Mock C et al. Guidelines to Essential Trauma
Care, 2004
Natural Disasters
Disaster
Serious event
where needs exceed the
local capacity to
respond WHO
Most victims of disaster
are usually also trauma
victims
Disasters
Natural
Disasters
Published Evidence
Australia: Smith et al (2004), Kumar et al
(2006)
Canada :Dyer et al ( 2008)
China: Wong et al (2006)
France: Knobloch et al (2009), Dulou et al
(2010)
Germany: Kreutzer et al (2008), Juhra et al
(2009)
Israel: Ashkenazi et al (2007) Todder et al
(2007)
Italy: Do Paolo et al (2009)
Published Evidence
Taiwan: Hsieh et al (2004),Tsai et al
(2007)
Thailand: Chandhanayingyon et al (2007)
United Kingdom: Keane (2009), Noble et al
(2005), Benger et al (2004)
USA: Sposaro and Tyson (2009), Saffle et
al (2006, 2009), Latifi et al (2007, 2009),
Waran et al (2008), Duchesne et al (2008),
Ma et al (2007), Kwon et al (2007),
Ngyuen et al(2004), Marcin et al (2004)
CASE PRESENTATION
Small
interventio
n
Pull the
ET tube back,
decompress
the stomach
Results:
Clinical
Improvement
Better SBP
Improvement
of Saturation
Extreme Conditions:
Low-bandwidth Portable
Satellite
Conclusion
Telemedicine in
acute phase injury :
works and it is
beneficial
Cost effective
Save lives
Safety and
practicality has
been demonstrated
Vastly
underutilized
Its time has come
The Greatest
Unused Tool !
What we
need to do?
Create
Infrastructure and
Connectivity
Policies, procedures, protocols
(both clinical and technical)
Credentialing process
Quality control
Cost
effective
Partnership
Between
healthcare
providers
Virtual Participation
Improving
Quality of
Patients
Care
Inaccuracy of Measurement of
Trauma & Injury
Unreliable measurement globally
GPS technology/satellite
Wireless technologies
Remote access to experts
Communications
Organization &
Coordination
Provide relief to disaster
management teams on
location
FAST
Emergency situations:
EMT lack of training
FAST technology applications
Boniface, K.S., Shokoohi, H., Smith, E.R., & Scantelbury, K. (2011). Teleultrasound and paramedics: real-time remote phyisician guidance of
the Focused Assessment with Sonography for Trauma examination.
American Journal of Emergency Medicine, 29, pp 477-481.
Telepointer Technology
Interaction style presentation system
interactive television, and other systems,
where the user is positioned at a remote
site from the display. The main function of a
telepointer is to point at the specific display
so that its motion could represent the
human gesture. Meanwhile, display devices
allow the collaborator to view the same
scene as seen by the other parties
Abdul Karim, R., Farizan Zakara, N. et al., (2013). Telepointer technology in
telemedicine: A review. Biomedical Engineering Online.
Telmedpak.com.
Www.suparco.gov.pk
Pakistan Telmedpak
SUPARCO, an
autonomous
research entity
under the federal
government has
recently launched
Pakistans First
Satellite based
telemedicine
network.
Recent Developments
Armenia
Mobile ECG Telemonitoring
Keeping up with
Industry Development
Dissolving legal barriers to industry
growth and development are key to
unlocking potential of the use of
telemedicine in disaster and trauma
management
Gupta, A. & McHugh, M. (2011). Keeping up with industry
development. pp. 373-388. In Telemedicine for Trauma,
Emergencies and Disaster Managment, R. Latifi, Ed.
Telemedicine for
Emergency
and Disaster
Pre
Event
Chaotic situation,
difficult to create
de novo programs,
short term, ?? utility
Most importantly
During
the Event
Media
Effect,
research
papers
Post
Event
Reconstruction
SUMMARY
Preparedness
Organization
Coordination
Communication
technology
Telemedicine
Saving lives!
There
Vacuum of hope
Digital divide was
getting bigger and
wider
What we do:
Change the delivery of existing medical care
We Demand
A new generation of leaders with
different intellectual capital and a new
direction
Disasters
Landmines & Unexploded Devices
57
Thank You!
latifi@iveh.org
rlatifi@email.arizona.edu