[Telemedical support in emergency medicine]

In July 1997 we began support of paramedics who would respond to emergency scenes using a telecommunications system based in the hospital emergency unit. However, since no telecommunications system that could be employed on the actual clinical site was available, we had to develop a new system. Our telecommunications system (TMS-6101, NIHON KOHDEN WELLNES Co., Tokyo, Japan) can transmit vital signs in real time and interactively transmit several types of moving images. Because the current infrastructure for radio communications cannot provide adequate telemedical support for paramedics, we are using the new system for clinical support between our unit and associated hospitals. Based on 57 cases of clinical telemedical intervention, the system has enabled high-quality decision making by specialists without the need for them to travel to the scene or transport X-rays films, ultrasonographic reports, or endoscopic results. If this newly developed telecommunications system is employed for telemedical interventions in medical facilities in remote areas or on remote islands, medical consultations for Japanese individuals overseas, night-time first aid in urban areas, and in disaster situations, the physicians on both side of the line will be able to obtain a wealth of timely information, greatly influencing outcome in both emergency and nonemergency cases.