Telemedicine in trauma care – Dr. Conor Deasy, Cork University Hospital
“TELEMEDICINE BRINGS THE DOCTOR & EXPERTISE TO THE ISOLATED ENVIRONMENT”
- 3G major advance; 90% of Uganda/Nigeria has access to 3G, but data encryption not possible.
- 8% of calls to Cork telemedicine line are about termination of resuscitation.
- Can support prehospital decision-making re. bypassing smaller units to get to definitive care.
- LifeBot5 = awesome toy; bidirectional video plus USS transmission.
- Fall detection by acclerometers in mobile phones. Just need the elderly to get iPhones…
- Telemedicine can reduce costs associated with unnecessary transfer flights.
- Virtual consults are very cost-effective ($6 million in one US study).
- Tele-ICU promising as a result of Lilly RCT [http://jama.jamanetwork.com/article.aspx?articleid=900247]
- In Arizona, blanket consent for filming and photography.
- Telemedicine may also have a future role for rehabilitation.
- Concerns remain regarding malpractice liability, but may actual decrease claims http://journals.lww.com/ccmjournal/Abstract/2014/11000/Critical_Care_Telemedicine___Evolution_and_State.14.aspx
Can trauma care be an elite sport? – Dr. Tom Evens, British Rowing Coach
“HIGH PERFORMANCE IS ABOUT DOING EVERYTHING IN THE BEST WAY”
- Parallels between high-performing trauma teams and high-performing athletes.
- Turn weaknesses into strengths.
- Need a common mental model to achieve aims.
- Only make mistakes once; debrief, learn and move on.
Primary Trauma Care: Trauma training in a low resource environment – Dr. Doug Wilkinson, Oxford.
- Trauma courses in developing world limited by cost, personnel and ownership.
- Courses need to depend less on equipment, use local teachers with no or minimal charge.
- Must be appropriate, affordable, adaptable and sustainable.
- To address this, the Primary Trauma Care (PTC) foundation was established [http://www.primarytraumacare.org/]
- 62 countries to date.
- Free course, information available on line. Manual can be downloaded at http://www.primarytraumacare.org/wp-content/uploads/2011/09/PTC-Manual_For-PTC-China_-June-2010-Edition.pdf
- The first part of the course is training the trainers, allowing the cascade of information and training throughout the country.
- Huge success: >1500 trained in 2014, 65% in rural locations.
- Difficult to prove benefit; RCTs not possible.