The need for a robust 24/7 subspecialty “clearing house” response for telementored trauma care

The need for a robust 24/7 subspecialty “clearing house” response for telementored trauma care

Can J Surg 2015;58(3):S85-S87 | PDF

Maj Andrew W. Kirkpatrick, MD; Douglas Hamilton, MD; Maj Andrew Beckett, MD; Anthony LaPorta, MD; Susan Brien MD, MEd; Col Elon Glassberg, MD, MHA; Chad G. Ball, MD, MSc; Derek J. Roberts, MD, MSc; Col Homer Tien, MD

Summary

Traumatic injury is increasing in importance in all settings and environments worldwide. Many preventable deaths are from conditions that are common and treatable. However, as potentially lethal injuries often induce progressive and frequently irreversible physiologic decline, the timing of interventions is critical. Invasive treatments may need to be offered by prehospital care providers who lack extensive training and practice. Telementoring allows experienced experts to guide less experienced providers remotely using information technology (IT). Early experience has shown that these techniques are practical and considered valuable. Their translation to regular practice, however, will require the immediate availability of appropriately trained remote experts willing to serve as mentors. Acute care trauma specialists are acclimatized to responding to out-of-hospital consultations and assuming overall responsibility for critical physiology and transport and may serve as the backbone of such a national/ international call response initiative.


The research group is jointly supported by the Canadian Forces Medical Services.

Accepted for publication Oct. 14, 2014

Affiliations: From the Regional Trauma Services, Calgary, Alta. ( Kirkpatrick, Ball, Roberts); Department of Surgery, University of Calgary, Calgary, Alta. (Kirkpatrick, Ball, Roberts); Canadian Forces Health Services (Kirkpatrick, Tien); Department of Medicine, University of Calgary, Calgary, Alta. (Hamilton); the 1 Canadian Field Hospital, Petawawa, Ont. (Beckett, Tien); Trauma Program, McGill University Health Centre, Montréal, Que. (Beckett); Rocky Vista School of Osteopathic Medicine, Parker, Colo. (LaPorta); Royal College of Physicians and Surgeons of Canada, Ottawa, Ont. (Brien); The Trauma & Combat Medicine Branch, Surgeon General’s HQ, Israel Defense Forces, Ramat Gan, Israel (Glassberg); Trauma Services and the Department of Surgery, Sunnybrook Medical Centre, Toronto, Ont. (Tien).

Competing interests: A.W. Kirkpatrick declares travel compensation from Innovative Trauma Care, LifeCell and Kinetic Concepts, all unrelated to the content of this article. A. LaPorta declares travel assistance through US federal grants during research for this product for the military.

Contributors: All authors contributed substantially to the conception, writing and revision of this commentary and approved the final version for publication.

DOI: 10.1503/cjs.013914

Correspondence to: A.W. Kirkpatrick, 1403 29 Street NW, Calgary, AB, T2N 2T9; andrew.kirkpatrick@albertahealthservices.ca