Telemedicine in trauma care: description of 100 trauma teleconsults

To study the role of telemedicine in the delivery of trauma care to rural providers on a telemedicine network.

A descriptive analysis of 100 trauma teleconsults over a private telemedicine network from February 1, 1995, through July 31, 1996.

Of 354 clinical teleconsults during the study period, 100 (28%) concerned trauma. The largest number of trauma teleconsults (54) were provided by orthopedic surgeons. Emergency physicians provided 33 teleconsults, radiologists 8, and neurosurgeons 5. The most common reasons for trauma teleconsults (94%) were diagnosis and treatment of extremity and pelvic injuries. The document camera was used for all teleconsults, primarily to transmit radiographs. The mean age of the patients was 32.3 years. Sixty-one of the teleconsults were categorized as urgent, 32 were emergency, and 7 were scheduled. The mean duration of the emergency teleconsults was 4.3 minutes, and the overall mean duration of all teleconsults was 8.6 minutes. Ninety of the trauma teleconsults occurred during regular week days, Monday through Friday. Radiologists reviewed all hardcopy radiographs and computed tomography films, and hard-copy interpretations were compared with interpretations at the time of the teleconsult. No significant discrepancies between the two modes of interpretation were noted. Of the 100 patients involved in trauma teleconsults, 68 stayed in the rural community. No significant adverse outcomes were observed among patients involved in teleconsults.

This analysis confirms the clinical effectiveness of telemedicine technology in the evaluation and treatment of extremity and pelvic injuries.