Journal of telemedicine and telecare
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There is a high prevalence of leprosy in the Amazon region of Brazil. We have developed a distance education course in leprosy for training staff of the Family Health Teams (FHTs). The course was made available through a web portal. ⋯ A total of 47 participants (98%) considered the course as excellent. The results demonstrate the feasibility of an interactive, tele-education model as an educational resource for staff in isolated regions. Improvements in diagnostic skills should increase diagnostic suspicion of leprosy and may contribute to early detection.
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We simulated a cardiopulmonary resuscitation (CPR) scene with a manikin and used two 3G videophones on the caller's side to transmit video to a laptop PC. Five observers (two doctors with experience in emergency medicine and three paramedics) evaluated the video. They judged whether the manikin was breathing and whether they would give advice for CPR; they also graded the confidence of their decision-making. ⋯ The video from the two 3G videophones that were tested was of sufficient quality for telephone CPR provided that camera orientation, distance, illumination and background were carefully chosen. Thus it seems possible to use 3G videophones for emergency calls involving CPR. However, further studies on the required video quality in different scenarios are necessary.
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Multicenter Study
Use of mobile phone cameras for after-hours triage in primary care.
Mobile phone images might be useful in after-hours triage of primary care. We conducted a study to identify population access to mobile phone cameras and to assess the clinical usefulness of mobile phone cameras. The survey was conducted among 480 patients attending two rural New Zealand practices. ⋯ Ten photographable clinical conditions were used to quiz 30 health professionals who were randomized into three groups of 10 each on diagnostic confidence. Images were found to significantly increase diagnostic confidence in all cases except one. It appears that mobile phone cameras are generally acceptable to patients and likely to be of practical use to rural practitioners in a range of clinical scenarios.
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We reviewed five years' experience of providing ground-to-air medical advice for commercial passenger aircraft. A total of 273 events occurred in-flight where further advice was sought. The most common age group resulting in calls were from those aged 21-30 years, who generated 38 calls (16%). ⋯ Most incidents were managed conservatively in-flight with oxygen and/or other medications. Aircraft diversion occurred on 9% of occasions; cardiovascular and neurological emergencies were the major cause of this. Collaboration between aviation providers should be considered to develop a common database of in-flight emergencies so that contents of medical kits can be standardized in order to improve the quality of care in the air.
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Multicenter Study
Teleradiology in neurosurgery: experience in 1024 cases.
Between June 1995 and June 2000 teleradiology was performed in 1024 neurosurgical cases (945 patients). An analogue image transfer system was used for presentation of computed tomography (CT) and magnetic resonance imaging (MRI) scans from seven referring hospitals in southern Germany. The system used a 19,200 baud modem connection via the ordinary telephone network. ⋯ If each patient had been transferred, then the potential savings for ground transportation were euro339.93 per case (with accompanying physician of the affiliated hospital) or euro373.96 per case (with accompanying experienced ICU physician), respectively (euro1 is US$1.4). The total cost of the image transfer system for all eight hospitals was euro96,000; this was amortised after 282 teleconsultations, which occurred after 15 months of usage. A simple teleradiology system in neurosurgery enables rapid and reliable telephone consultations, mainly on patients with trauma, stroke and intracerebral haematoma at low cost.