Background: Patients requiring time-critical emergency care in remote areas are disadvantaged. This project aims to facilitate immediate pre-hospital assessment using remotely supported ultrasound (US) and a novel communications device. Non-specialist clinicians could function as remotely supported US operators guided and advised by hospital-based specialists regarding diagnosis and treatment options.
Aims: To identify the effects of image transmission, scanning experience and reviewer experience in achieving a diagnostically useful US image.
Method: An ambulance-based US machine captured standard trauma and novel trans-cranial US scans from 10 healthy volunteers at 16 locations across the Scottish Highlands. Images from novice and expert scanners were streamed with an audio/video feed via a novel satellite/cellular communications device to reviewers in Inverness for interpretation. Novice scanners received expert guidance via the communications link. The time taken by clinical reviewers with varying levels of US experience to confirm a diagnostically-useful image was compared to the time taken by a radiologist.
Results: Remote connections were successfully established at 15/16 sites. Image transmission and scanning experience were found to have a statistically significant impact on the time taken to achieve a useful diagnostic image. Differences in reviewer experience did not produce a significant effect.
Conclusions: Time to diagnosis could be significantly improved if pre-hospital scanners receive training and gain experience using US and have stable, reliable transmission of images to expedite remotely-supported diagnosis. This pre-hospital support US system needs further evaluation but has the potential to facilitate early diagnosis and the streamlining of treatment pathways for remote and emergency patients.
This abstract was presented at the Innovative Solutions in Remote Healthcare - 'Rethinking Remote' conference, 23-24 May 2016, Inverness, Scotland.