LTC 2014 Session 2

Summary of second morning session at the 2014 London Trauma Conference. The full programme of the meeting can be found here.

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.
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