Search

Introduction: Smartphones can be used to record and transmit high-quality clinical photographs. The aim of this study was to describe our experience with smartphone telephotography in the care of trauma patients. We hypothesized that smartphone telephotography can be safely and effectively implemented on a trauma service. Subjects and Methods: We performed a 2-year (January 2011-December 2012) prospective analysis of all patient photographs recorded by members of our trauma team at our Level I trauma center. All members of the trauma team recorded patient photographs and e-mailed them to a secure e-mail account. An administrative assistant uploaded a copy of each photgrapho into the patient's electronic medical record. We assessed the number of photographs collected and uploaded, as well as the success, failure, and complication rates. Results: Our trauma team sent 7,200 photographs to a secure e-mail account. Of those, 6,120 (85%) were considered, after an initial review, to be of good quality. Of these, 3,320 photographs (54%) were successfully uploaded into a patient's electronic medical record; the remaining 2,800 photographs lacked adequate labeling and could not be uploaded. The average interval to uploading was 3 months. In total, 10 photographs were uploaded into the wrong patient's electronic medical record, for an error rate of 0.003%. We received only three complaints during the study period. Conclusions: Telephotography can be safely and effectively implemented in trauma clinical practice. Fears of Health Insurance Portability and Accountability Act violations are not valid, as the incidence of patient complaints is minimal when telephotography is implemented under strict guidelines and rules. Dedicated administrative personnel are essential for effective implementation of smartphone photography. [ABSTRACT FROM AUTHOR]

Introduction: Communication among healthcare providers continues to change, and 90% of healthcare providers are now carrying cellular phones. Compared with pagers, the rate and amount of information immediately available via cellular phones are far superior. Wireless devices such as smartphones are ideal in acute trauma settings as they can transfer patient information quickly in a coordinate manner to all the team members responsible for patient care. Subjects and Methods: A questionnaire survey was distributed among all the trauma surgeons, surgery residents, and nurse practitioners who were a part of the trauma surgery team at a Level 1 trauma center. Answers to each question were recorded on a 5-point Likert scale. The completed survey questionnaires were analyzed using Statistical Package for Social Sciences software (SPSS version 17; SPSS, Inc., Chicago, IL). Results: The respondents had an overall positive experience with the usage of the third-generation (3G) smartphones, with 94% of respondents in favor of having wireless means of communication at a Level 1 trauma center. Of respondents, 78% found the device very user friendly, 98% stated that use of smartphones had improved the speed and quality of communication, 96% indicated that 3G smartphones were a useful teaching tool, 90% of the individuals felt there was improvement in the physician's response time to both routine and critical patients, and 88% of respondents were aware of the rules and regulations of the Health Insurance Portability and Accountability Act. Conclusions: Smartphones in an acute trauma setting are easy to use and improve the means of communication among the team members by providing accurate and reliable information in real time. Smartphones are effective in patient follow-up and as a teaching tool. Strict rules need to be used to govern the use of smartphones to secure the safety and secrecy of patient information. [ABSTRACT FROM AUTHOR]

Introduction: Since the first remote intubation with telemedicine guidance, wireless technology has advanced to enable more portable methods of telemedicine involvement in remote airway management. Materials and Methods: Three voice over Internet protocol (VoIP) services were evaluated for quality of image transmitted, data lag, and audio quality with remotely observed and assisted intubations in an academic emergency department. The VoIP clients evaluated were Apple (Cupertino, CA) FaceTime®, Skype™ (a division of Microsoft, Luxembourg City, Luxembourg), and Tango® (TangoMe, Palo Alto, CA). Each client was tested over a Wi-Fi network as well as cellular third generation (3G) (Skype and Tango). Results: All three VoIP clients provided acceptable image and audio quality. There is a significant data lag in image transmission and quality when VoIP clients are used over cellular broadband (3G) compared with Wi-Fi. Conclusions: Portable remote telemedicine guidance is possible with newer technology devices such as a smartphone or tablet, as well as VoIP clients used over Wi-Fi or cellular broadband. [ABSTRACT FROM AUTHOR]

Background: Basidiobolomycosis is a rare fungal infection caused by the fungus Basidiobolus ranarum. Gastrointestinal basidiobolomycosis (GIB) is an unusual presentation of the fungal infection that is reported sparsely in the literature, but is an emerging infection in the southwestern United States. Lack of awareness of GIB has resulted in its delayed diagnosis and in extensive morbidity and mortality in patients with GIB. Methods: Case report and literature review. Case Report: We report the rare case of a young female with GIB that presented as perforated appendicitis with abscess formation. Conclusion: Although GIB is rare, immediate and aggressive therapy should be initiated when it is diagnosed. Both long-term medical and surgical treatment is required for its definitive management. [ABSTRACT FROM AUTHOR]

Rural trauma care has been regarded as being the 'challenge for the next decade.' Trauma patients in rural areas face more struggles than their urban counterparts because of the absence of specialized trauma care, delay in providing immediate care to trauma victims, and longer transport times to reach a trauma center. Telemedicine is a promising tool for facilitating rural trauma care. This stellar tool creates a real-time link between a remotely located specialist and the local healthcare provider, especially during the initial management of the trauma patient, involving resuscitation and even intubation. However, the high cost of purchasing, setting up, and maintaining all the needed equipment has made telemedicine an expensive proposition for rural hospitals, which frequently have limited budgets. But recently, new improvements in communication technology have made smartphones an indispensable part of daily life, even in rural areas. These devices have great potential to improve patient care and enhance medical education because of their wide adoption and ease of use. In this article, we describe our initial teletrauma experience and the effect of smartphone implementation in patient care and medical education at the University of Arizona Medical Center in Tucson. [ABSTRACT FROM AUTHOR]