Sometimes you just wish that the doctor on the phone was standing right next to you to actually see what you’re seeing.
Well, that’s possible.
Telemedicine has more purpose and application than just mobile integrated healthcare environments; it can be used in your everyday 911 response EMS system, on every ambulance.
Medical control consult
Consider: You’re at a residence with a mother and her six-year-old son, who has experienced an asthma exacerbation after physical exertion. Mom has already administered her son’s prescribed inhaler, and you’ve arrived on scene to find a patient with mild wheezing that has improved overall. Mom now decides that she’ll keep her son home and monitor him for any return exacerbation.
Instead of calling your medical control physician, you hold a telemedicine phone conference so she can lay eyes on the patient, and speak directly with the mother and patient. Technology advancements may even allow you to record a digital auscultation of the patient’s lung sounds for the physician to hear directly.
Connecting to a 4G LTE/5G network can allow you the advanced speed, bandwidth and capability to make this possible. Add in the right equipment, and your ambulance can transform into a mobile physician-accessible clinic, even for patient releases and consults.
Stroke, time-critical medical calls
Slurred speech and unilateral extremity weakness; sounds like a stroke, right?
In the right context, you’re greater than 80% correct. But, could there be more to the equation?
Let’s say that you’re about 15 minutes away from a primary stroke center and 25 minutes away from a comprehensive stroke center with endovascular thrombectomy care available. The patient’s last known well (symptom onset) time was six hours ago (which you document as the actual clock time ... not just “six hours”).
Now, where should you transport your patient?
Well, you consult with the ED physician, who immediately transfers you to the on-call neurologist. He asks the patient a few more questions, has him perform a few more tasks, and determines that the patient also has neglect: a cortical sign of a large vessel occlusion stroke.
You’re directed to transport to the further comprehensive center because of the symptom onset timeframe and the neurologist consults with the interventional team as you begin your transport. You very likely saved the patient from further deficit because of this decision and maybe even saved his life.
MCI, major trauma events
A picture says a thousand words, so does that mean a video says a million?
The future is upon us. Some EMS agencies are already wearing body cameras as they enter scenes, now imagine integrating that camera into a broadband network that links it to a live portal for an emergency physician to watch. Talk about bringing the doc to the scene with you!
As you approach the first vehicle of the MVC incident you’ve responded to, you observe an alert patient with an intact airway. You categorize them as “green” and move along.
The next car has a patient that is slouched over, unresponsive and has a rapid pulse; red tag.
The physician observing you begins activating trauma teams at the hospital level, begins briefing emergency department staff of the patients that you’re assessing, and starts coordinating MCI operations and transport with the on-scene incident commander.
This is what interactive MCI and trauma telemedicine can look like.
With the right tools in your toolbox (or on your 4G LTE/5G network), you can turn any scene or situation into a secure broadcast for physicians, specialists and command staff to see live. This is the future of telemedicine for 911-based ambulance services, and the future is now.
This article, originally published in May 2019, has been updated.
