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Two different prototype mobile telemedicine systems were constructed for use in the emergency room. They could transmit physiological signals as well as video pictures and sound. One device, the mobile emergency bed (MEB), was powered by battery and had a wireless connection to the local-area network (LAN). For the other, the mobile emergency server (MES), a patient monitor, video-camera and microphone were connected by a radio-frequency link to a server. A functional evaluation and a clinical evaluation (by 12 emergency doctors in six emergency centres) were performed on both prototypes. The bandwidth and the video quality of the MEB were better than those of the MES, because of the digital transmission of the wireless LAN. The MES was better for directing patient treatment and teleconsultation; the MEB was better for static patients in the emergency centre. In general, the MES was more suitable for practical emergency telemedicine work. [ABSTRACT FROM AUTHOR]

We developed a telemedicine system for remote guidance of emergency airway management called the Tele-Airway Management System (TAMS). In a pilot study we examined the usefulness of the TAMS for intubations of actual patients in a hospital emergency department. Twenty-five patients were allocated randomly either to a TAMS group or to an on-scene directed (OSD) group. A total of 12 were intubated using the TAMS. The mean time to intubation (TAMS 62 s vs. OSD 56 s) and the success rate was not different between the two groups (P . 0.05). There were two oesophageal intubations in theTAMS group and four in the OSD group, but this was not significantly different (P ¼ 0.36). There were no mechanical or technical errors such as disconnection during use of the TAMS. The pilot study demonstrated the feasibility of the TAMS as an alternative to OSD. However, a larger study will be required to determine non-superiority or equivalence. [ABSTRACT FROM AUTHOR]

We developed a Tele-Airway Management System (TAMS) which contained two high quality videocameras which were set up to view the frontal and lateral parts of the patient. Another endoscopic camera, a videolaryngoscope, was used to view the anatomy of the airway. One patient monitor was used to view the vital signs and there was also a PC terminal. A study was conducted in two separate emergency departments with 33 novice intubators (medical students and interns of the department). Remote consultation was provided by a board certified emergency physician. The time taken to complete endotracheal intubation for the TAMS group was 82.1 s (SE 4.9) and was 103.8 s (SE 7.9) in the videolaryngoscope-only group. The difference was significant (P = 0.03). The success rate of endotracheal intubation within 2 min was 94% for the TAMS group and 63% in the videolaryngoscope-only group (P = 0.04). With a wireless communication system, the TAMS could be installed in an ambulance, which might allow paramedics to perform safe and effective airway management in the field. [ABSTRACT FROM AUTHOR]