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Skriv till oss och ge oss signaler om det önskem ålet i s å fall!
Karl-Axel Wallman-C:son
chefredaktör
Fotnot: Här under kan du se listan om telemedicin som ing år i den vetenskapliga sökningen.
Litteratursammanställning av ambulanslitteratur 1998-10-28.
Observera att denna sammanställning är gjord på kombination av sökbegrepp, som bör fånga "prehospital, ambulans, transport" m m i kombination med "Telemedicin och Kommunikation".
Ambulansforum har strävat efter att göra listan så heltäckande som möjligt på detta område avseende litteratur fr o m 1995. Vi kan emellertid aldrig garantera att den är heltäckande. Listan omfattar litteratur från indexerade vetenskapliga tidskrifter. Icke indexerade tidskrifter, lokalt producerade arbeten som vetenskapliga avhandlingar och uppsatser ingår således ej, inte heller läroböcker eller annat material i bokform.
Listan är sorterad efter publikationsmånad (fallande ordning).
Några av referenserna kan förefalla att ligga utanför ämnet. Uppenbarligen sker indexeringen på "Transportation-of-patients" så att även metoder, som leder till att patienten inte behöver transporteras medtages. Därför har dessa referenser likväl fått ligga kvar i listan
1.
Telemed J
1998
4
:
49
-
54.
Brunicardi BO:
Financial analysis of savings from telemedicine in Ohio's prison system.
The Ohio Department of Rehabilitation and Corrections (ODRC) implemented a telemedicine pilot project in March of 1995. The project brought together the Southern Ohio Correctional facility in Lucasville, the Corrections Medical Center in Columbus, and The Ohio State University Medical Center, also located in Columbus. Its purpose was to evaluate the use of two-way interactive video for the delivery of health services. With two-way interactive video, physicians in one location established audio and video links with inmates hundreds of miles away. Data were collected on the potential savings as a result of telemedicine usage in the Ohio prison system. Costs associated with telemedicine and those incurred without telemedicine were determined on per-consult basis for comparison. The cost for a medical consult to be performed at the Corrections Medical Center averaged $263.51 per inmate. The cost for a medical consult via telemedicine varied from month to month, depending on the utilization volume. The ODRC experienced savings for telemedicine usage when 129 or more consults were performed each quarter. During the third quarter, 145 telemedicine consults were performed. The cost per consult for telemedicine usage during this quarter was $255.19. There was a savings of $8.48 per consult, resulting in a quarterly savings of $1206. As the utilization of telemedicine continued to increase in the fourth quarter, the amount of savings increased.
Continuity of Patient Care/ Costs and Cost Analysis/ Delivery of Health Care economics/ Delivery of Health Care methods/ Health Care Costs/ Nursing Services economics/ Ohio/ Pilot Projects/ Remote Consultation instrumentation/ Transportation of Patients economics/ Prisons/ Remote Consultation economics/
Comparative Study; Human;
2.
Tidsskrift for den Norske Laegeforening
1998
118
:
2634
-
2635.
Fystro R, Soyseth V, Vandvik PO:
Kjeden som redder liv. Prehospital behandling av hjerteinfarkt.
English title: "The chain that saves life. Prehospital treatment of myocardial infarction"
A 53-year old woman living in a rural area 220 km from the nearest hospital experienced an acute myocardial infarction. The local doctor contacted the emergency service and requisitioned an air ambulance. 29 minutes later the physician-manned helicopter arrived, and thrombolytic treatment was started after 15 minutes. The patient arrived at the county hospital 35 minutes later, after having been electroconverted three times because of ventricular fibrillation. The patient was discharged from hospital ten days later with no cerebral sequelae, and left ventricular ejection fraction 49%. This example shows that active use of emergency communications systems and air ambulances enables both prompt thrombolytic treatment and the effective treatment of complications associated with myocardial infarction to be accomplished.
Electric Countershock/ Emergency Medical Services organization and administration/ English Abstract/ Middle Age/ Norway/ Remote Consultation/ Air Ambulances/ Emergency Medical Service Communication Systems/ Emergency Medical Services/ Myocardial Infarction drug therapy/ Thrombolytic Therapy
Case Report; English Abstract; Female; Human;
Address: Norsk Luftambulanse, Dombas.
3.
J Telemed Telecare
1998
1
:
5
-
7.
Giovas P, Papadoyannis D, Thomakos D, Papazachos G, Rallidis M, Soulis D, Stamatopoulos C, Mavrogeni S, Katsilambros N:
Transmission of electrocardiograms from a moving ambulance.
Delay is the enemy for patients with acute myocardial infarction. It would be helpful for the hospital cardiologist to interpret the patient's electrocardiogram (ECG) before the arrival of the ambulance. The aim of our study was to determine whether ECG transmission from an ambulance is feasible and to assess the time savings. An ambulance was equipped with an ECG recorder, which was connected to a notebook computer and coupled to a cellular telephone for transmission to a hospital-based station. Paramedics needed 2 min (SD 0.5) to record the ECG on the move and 34 s (SD 14) to transmit it. The ambulance arrived 15.5 min (SD 6.5) after reception. The time between arrival and ECG diagnosis, for a control group patient, was approximately 9.5 min (SD 3.5). Therefore, pre-hospital ECG diagnosis took place 25 min (SD 7.5) before in-hospital diagnosis. We conclude that ECG transmission from a moving ambulance is feasible, reduces in-hospital delays and allows faster triage in critical cardiac cases.
Greece/ Pilot Projects/ Thrombolytic Therapy/ Time Factors/ Triage methods Ambulances/ Electrocardiography/ Myocardial Infarction diagnosis/ Telemedicine methods/ Telemetry methods/
Human; Support, Non U.S. Gov't;
Address: 1st Department of Propaedeutic Medicine, Athens University School of Medicine, Greece.
4.
Prehosp Emerg Care
1998
2
:
189
-
191.
Hobbs GD, Moshinskie JF, Roden SK, Jarvis JL:
A comparison of classroom and distance learning techniques for rural EMT-I instruction.
<No comments available>
5.
J Telemed Telecare
1997
3
:
194
-
199.
Bergmo TS:
An economic analysis of teleconsultation in otorhinolaryngology.
A cost comparison of three different methods of providing consultations for ear, nose and throat (ENT) problems was carried out. The study was based on the delivery of ENT examination and treatment to a small primary-care centre without an ENT specialist in northern Norway. The three alternatives evaluated were teleconsultation, a visiting specialist and patient travel to the nearest secondary-care centre. Patient travel was cheaper for patient workloads below 56 per year. For patient workloads above 56 and below 325 patients per year teleconsultation was the cheapest alternative. Above 325 patients per year, the visiting specialist service cost less than either teleconsultation or patient travel. Transfer of medical skills from the specialist to the general practitioner was also accounted for, separately from the main cost calculation. Teleconsultation then became cost-effective for patient workloads above 52 patients per year.
Costs and Cost Analysis/ Evaluation Studies/ Norway/ Otolaryngology methods/ Transportation of Patients economics/ Workload/ Otolaryngology economics/ Remote Consultation economics/
Comparative Study; Human;
Address: Department of Telemedicine, University Hospital of Tromso, Norway. tmatsb@rito.no
6.
Computer Methods and Programs in Biomedicine
1997
54
:
131
-
139.
Engelmann U, Schroter A, Baur U, Werner O, Goransson B, Boralv E, Schwab M, Muller H, Bahner M, Meinzer HP:
Experiences with the german teleradiology system MEDICUS.
This paper introduces the teleradiology system, MEDICUS, which has been developed at the Deutsches Krebsforschungszentrum (German Cancer Research Center) in Heidelberg, Germany. The system is designed to work on ISDN lines as well as in a local area network. The global software architecture is explained in the article. Special attention has been given to the design of the user interface and data security, integrity and authentication. The software has been evaluated in a German field test at 13 radiology departments in university clinics, small hospitals, private practices and research institutes. More than 30 thousand images have been transmitted using this system during a 9 month period. Realized application scenarios are: in-house communication, image and report delivery to referring hospitals, remote reporting, radiotherapy treatment planning and research cooperation. Experience has shown that the system is easy to use and saves time. It obviates the need for patient transport and reduces film costs. Experiences of individuals while using the system during the field test helped define the functionality of the second generation teleradiology system which is even more flexible and is also available as a commercial product.
Computer Communication Networks/ Computer Security/ Cost Control/ Germany/ Hospitals/ Hospitals, University/ Local Area Networks/ Medical Records/ Patient Care Planning/ Private Practice/ Radiology/ Radiology Department, Hospital/ Radiology Information Systems/ Radiotherapy/ Referral and Consultation/ Research/ Software/ Software Design/ Software Validation/ Transportation of Patients/ User Computer Interface/ X Ray Film economics/ Teleradiology
Human
Address: Division of Medical and Biological Informatics, Deutsches Krebsforschungszentrum, Heidelberg, Germany. U.Engelmann@DKFZ-Heidelberg.de
7.
J Telemed Telecare
1997
3
:
200
-
204.
Finley JP, Sharratt GP, Nanton MA, Chen RP, Bryan P, Wolstenholme J, MacDonald C:
Paediatric echocardiography by telemedicine--nine years' experience.
In 1987 we established a realtime echocardiography service by telemedicine from the paediatric cardiology department of a tertiary-care hospital in Halifax. The service was initially provided to single regional hospital but was expanded to six regional hospitals in the three Canadian Maritime Provinces. The system used a dial-up broadband video-transmission service provided by the telephone companies. Records of all transmissions were kept prospectively and reviewed to January 1997. A total of 324 transmissions were made. During 1995-96 there were 135 studies: 69 (51%) were urgent examinations of newborn children and 30 (22%) were urgent examinations of older children; repeat studies and postoperative checks (usually for pericardial effusion) accounted for the other 36 studies (27%). The images were of broadcast quality except in five cases where problems with transmission or poor sedation occurred. A comparison of 26 transmitted studies with repeat, 'in person' studies showed no important discrepancies in diagnosis. During the two-year study period, the cost of the network (equipment leasing costs and telecommunications costs) was C$90,000. Use of the telemedicine network saved unnecessary patient transfer in 31 cases. The cost of the transportation avoided was C$100,000-C$118,000. This review confirms our preliminary findings that broadband echocardiography transmission provides a service comparable in availability and accuracy to that provided in our paediatric cardiology division.
Canada/ Child/ Child, Preschool/ Costs and Cost Analysis/ Evaluation Studies/ Infant/ Infant, Newborn/ Pediatrics economics/ Prospective Studies/ Telemedicine economics/ Telemetry/ Transportation of Patients economics Echocardiography/ Pediatrics methods/ Telemedicine methods/
Human
Address: Department of Pediatric Cardiology, IWK Grace Health Centre, Halifax, Nova Scotia, Canada. jfinley@iwkgrace.ns.ca
8.
Proc-AMIA-Annu-Fall-Symp. 1997: 383-7
1997
383
-
387.
Gagliano DM, Xiao Y:
Mobile Telemedicine Testbed.
Ambulances/ Cerebrovascular Disorders/ Emergency Medical Services methods/ Evaluation Studies/ Local Area Networks/ Telemedicine instrumentation/ Transportation of Patients/ Emergency Medical Service Communication Systems/ Emergency Medical Services/ Telemedicine/
Human; Support, U.S. Gov't, P.H.S.;
Address: Information Sciences Division, BDM Federal, McLean, VA, USA.
9.
British Journal of Neurosurgery
1997
11
:
52
-
56.
Goh KY, Lam CK, Poon WS:
The impact of teleradiology on the inter-hospital transfer of neurosurgical patients.
The aim of this study was to examine the role of teleradiology in the management of inter-hospital transfer of neurosurgical patients, especially in terms of safety and early therapeutic interventions. Data were collected prospectively, comparing events during the inter-hospital transfer of patients from a district general hospital to a tertiary neurosurgical centre, before and after teleradiology became available. From March to December 1995, 50 referrals made without teleradiology were compared with 66 referrals after teleradiology installation. Our results showed that for patients referred with teleradiologic images, unnecessary transfers were reduced (21%), more therapeutic measures before transfer were implemented (27% vs 20%, p = 0.41), adverse events occurring during transfer were significantly reduced (8% vs 32%, p = 0.002), and transfer time was shortened (72 min vs 80 min, p = 0.38). The potential advantages of this system in facilitating safer transfers and faster management of neurosurgical emergencies therefore merit further attention.
Adolescence/ Adult/ Aged/ Aged, 80 and over/ Child/ Child, Preschool/ Emergencies/ Infant/ Middle Age/ Prospective Studies/ Treatment Outcome Cerebrovascular Disorders radiography/ Head Injuries radiography/ Teleradiology/ Transportation of Patients/
Comparative Study; Female; Human; Male;
Address: Department of Surgery, Prince of Wales Hospital, Chinese University of Hong Kong, Shatin, Hong Kong.
10.
International Journal of Gynaecology and Obstetrics
1997
2
:
S157
-
S164.
Samai O, Sengeh P:
Facilitating emergency obstetric care through transportation and communication, Bo, Sierra Leone. The Bo PMM Team.
<No comments available>
11.
Veterinary and Human Toxicology
1997
39
:
170
-
172.
White NC:
Poisons and panic!.
<No comments available>
12.
J Telemed Telecare
1996
1
:
76
-
79.
Adeyinka M:
The teleambulance.
The teleambulance aims to facilitate adequate medical treatment by initiating and guaranteeing maximum preparation and immediate hospital handling of the patient either at the scene of an incident or during transportation. Following the problem definition and the identification of the medical fields the technology can address, field research was conducted to investigate the state of the art from the point of view of the prospective end user. This paper presents the development of the teleambulance workstation.
Monitoring, Physiologic/ Netherlands/ Software/ Wounds and Injuries therapy Ambulances/ Telemedicine/
Human
Address: Instituut Voor Telemedische Applicaties, Laboratorium Voor Biomedische Informatica, The Netherlands. michael@lbmi2.hobby.nl
13.
J Telemed Telecare
1996
1
:
82
-
83.
Darkins A, Fisk N, Garner P, Wootton R:
Point-to-point telemedicine using the ISDN.
Two pilot telemedicine trials were established, one using basic-rate ISDN (minor injuries service) and one using primary-rate ISDN (remote fetal scanning). Preliminary results were most encouraging. In the first 10 months of operation, 49 patients with minor injuries were managed successfully using telemedicine. Preliminary calculations suggest that the use of a low-cost telemedicine link was extremely cost-effective in comparison with the cost of providing conventional medical cover. In the first six months of operation the fetal scanning link was used for 39 consultations in 29 patients. In 25 cases (86%) a definitive diagnosis was made using the telemedicine link and physical referral was avoided. However, the current cost of the required hardware (approximately 35,000 pounds per end) is likely to militate against the widespread introduction of the technique, especially since the principal savings are intangible from the perspective of any hospital considering purchase. From the point of view of its use as an information transport system for telemedicine, the ISDN proved reliable (only one failure to establish a connection on demand). Picture quality was acceptable in most cases.
Emergency Nursing/ Great Britain/ Nurse Practitioners/ Pilot Projects/ Wounds and Injuries therapy/ Computer Communication Networks/ Emergency Medical Services/ Fetal Diseases ultrasonography/ Remote Consultation organization and administration
Human
Address: Riverside Community Trust, London, UK.
14.
Resuscitation
1996
31
:
33
-
38.
Lester C, Donnelly P, Weston C, Morgan M:
Teaching schoolchildren cardiopulmonary resuscitation [see comments].
<No comments available>
15.
Resuscitation
1996
32
:
23
-
26.
Meron G, Frantz O, Sterz F, Mullner M, Kaff A, Laggner AN:
Analysing calls by lay persons reporting cardiac arrest.
<No comments available>
16.
Cahiers d'Anesthesiologie
1995
43
:
401
-
412.
Barrier G:
Rapport sur la prise en charge prehospitaliere des urgences.
English title: "Report on the prehospital management of emergencies"
France/ Mobile Health Units/ Transportation of Patients/ Education, Medical/ Emergency Medical Services organization and administration/ First Aid/ Telemedicine
Human
17.
Surgery
1995
118
:
789
-
794.
Gerndt SJ, Conley JL, Lowell MJ, Holmes J, Marsh E, Larin LR, Taheri PA, Polley TZ, Rodriquez JL:
Prehospital classification combined with an in-hospital trauma radio system response reduces cost and duration of evaluation of the injured patient.
<No comments available>
18.
Masui
1995
44
:
890
-
894.
Shindoh M, Nishi S, Kurita S, Hayashi M, Yukioka H, Fujimori M:
[Tele-ECG transmission for patients with out-of-hospital cardiac arrest in Osaka City.].
The efficacy of a tele-ECG transmission system for transmission of electrocardiograms from ambulance to Osaka City University Hospital for 59 patients with out-of-hospital cardiac arrest was evaluated from December 1992 to November 1993. Authorized emergency life saving technicians (ELSTs) transmitted electrocardiograms by automobilephone connected with electrocardiogram from the location of out-of-hospital cardiac arrest recognized by them to the ICU. Successful tele-ECG transfer was achieved in 34 cases (57.6%). The most common reason for failure of transmission was interference by large buildings located in our urban location, which occurred in 12 of the 25 cases. Defibrillary shock was applied in 9 of 10 cases of ventricular fibrillation, and one patient among them could return to work. In most cases, laryngeal mask airway insertion was performed. The group with tele-ECG transmission required longer time for transfer to the hospital. The time required for insertion of the laryngeal mask airway and tele-ECG transmission appeared to be the main reason for the delay in transport. Although use of tele-ECG transmission can be useful for patients with out-of-hospital cardiac arrest, further improvement on the transmission system will be needed.
Adult/ Aged/ Emergency Medical Technicians/ English Abstract/ Heart Arrest therapy/ Japan/ Laryngeal Masks/ Middle Age/ Electrocardiography/ Emergency Medical Services/ Heart Arrest diagnosis/ Telemedicine/
English Abstract; Female; Human; Male;
Address: Department of Emergency Medicine, Osaka City University Hospital.
19.
J Telemed Telecare
1995
1
:
54
-
60.
Siderfin CD:
Low-technology telemedicine in Antarctica.
Accidents, Aviation/ Antarctic Regions/ Constipation complications/ Hematuria etiology/ Multiple Trauma complications/ Quality Control/ Technology, Medical/ Virus Diseases complications Fractures diagnosis/ Head Injuries diagnosis/ Multiple Trauma diagnosis/ Questionnaires/ Remote Consultation methods/ Transportation of Patients/ Virus Diseases diagnosis
Case Report; Human; Support, Non U.S. Gov't;
Address: British Antarctic Survey Medical Unit, RGIT Limited, Aberdeen, UK.
20.
Journal of Medical Systems
1995
19
:
139
-
142.
Smits HL, Baum A:
Health Care Financing Administration (HCFA) and reimbursement in telemedicine.
Telemedicine has real potential to improve the availability of services and advice of medical specialists to primary care practitioners and their patients. Use of the term "telemedicine" for the purposes of this article will refer to two-way, interactive video systems over which medical consultation takes place. This does not include the use of telecommunications technology to transport still images, particularly radiologic images, from one site to another. We are quite aware that teleradiology and telepathology is already in common use in many sites. We are currently exploring the question of quality standards for teleradiology in addition to other forms of telemedicine.
Emergency Medical Services/ Financing, Government/ Insurance, Health, Reimbursement economics/ Medicare/ Telemedicine legislation and jurisprudence/ United States/ Research Support/ Telemedicine economics/ United States Health Care Financing Administration
Huma
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