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Teletrauma: Preliminary Design & Findings From Vermont’s Rural Telemedicine Network

Teletrauma: Preliminary Design & Findings From Vermont’s Rural Telemedicine Network. Michael Caputo, MS Michael Ricci, MD Frederick Rogers, MD Ken Sartorelli, MD. Medical Disaster Conference: June 14, 2001. Rural Trauma Problems. Discovery - Late. Rudimentary Prehospital Capabilities.

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Teletrauma: Preliminary Design & Findings From Vermont’s Rural Telemedicine Network

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  1. Teletrauma: Preliminary Design & Findings From Vermont’s Rural Telemedicine Network Michael Caputo, MS Michael Ricci, MD Frederick Rogers, MD Ken Sartorelli, MD Medical Disaster Conference: June 14, 2001

  2. Rural Trauma Problems • Discovery - Late • Rudimentary • Prehospital Capabilities • Prolonged Transport • Times

  3. Could Telemedicine be used in Vermont’s “hostile” rural environment?

  4. A Trauma Solution? Use TMED to bring the eyes and ears of an experienced trauma surgeon into the community hospital to help with the initial stabilization of a trauma patient.

  5. U.S. Department of Commerce • Technologies Opportunities Programs (TOP) • $300,000 in matching funds • http://www.ntia.doc.gov /oiahome/top/index.html

  6. Telemedicine System • Desktop System • ISDN, 384 kbps • Intel microprocessor • 17” Sony Monitor • Zydacron Z250 video conferencing board • Zydacron Z206 multiple BRI comm board

  7. Implementation + + + + + 4 Trauma Sites & 3 Surgeon’s homes

  8. Trauma TMED Protocol Any one of the following: þ 1. GCS < 13 þ 2. Hypotension (systolic BP < 90 mmHg) þ 3. Penetrating truncal trauma þ 4. Respiratory Distress (10 > RR< 30) Continued è

  9. Trauma TMED Protocol þ 5. Amputation proximal to the wrist or ankle. þ 6. Any patient not meeting the above criteria for whom the treating physician feels it is appropriate to call a telemedicine consult.

  10. Electronic Eyes & Ears

  11. Results • 26 tele-trauma consults (4/2000 - 1/2001) • Ages 14 - 81 years old • 96% blunt mechanism • 50% MVC, 12% ATV, 12% pedestrian struck

  12. 2 Cases of Potentially Lifesaving Tele-trauma Consults Case #1 41 year-old with severe CHI unable to intubate Emergent cricothyroidotomy Continued è

  13. 2 Cases of Potentially Lifesaving Tele-trauma Consults Case #2 24 year-old severe multi-trauma hypotensive, severe CHI DPL -> to OR for control of intracavitary hemorrhage

  14. Technical Problems • 4 times unable to connect • Remote control failure • Audio failure

  15. Conclusion • Tele-trauma enhances rural trauma care • Rapid response • 2 lives potentially saved. • well received by rural trauma providers. • Occasional technical difficulties

  16. Questions? Michael Caputo, MS Director of Information Services & Director of Telehealth Operations University of Vermont – College of Medicine (802) 656-9658 michael.caputo@uvm.edu

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