Dates:
December 2015 to March 2019
Overview and Aims:
In time-critical medical emergencies occurring in remote prehospital environments, minutes can make the difference between life and death; disability and recovery; reducing the time it takes to diagnose and treat a patient can lead to fundamental improvements in emergency medical care. The objective of the SatCare project is to extend the capabilities of paramedics, allowing live interaction with remotely-based doctors and equipment, and allowing the team to deliver the correct treatment immediately, both at the place of intervention and during transport.
Reliable broadband connectivity could potentially allow enhanced interaction between ambulance clinicians and hospital-based emergency medical experts. Such interaction could involve transmission of audio/video streams as well as physiological monitoring data and ultrasound images. The result could be improved decision support outside the hospital leading to better prehospital management (e.g., surgical management of pneumothorax, thrombolysis decisions, or decisions on whether hospital transfer is required) and more streamlined management on arrival in hospital (such as immediate transfer to a staffed operating theatre). The end result could potentially be improved survival, reduced morbidity and consequent reduced health service and social costs.
SatCare is a randomised controlled trial involving rapid standardised ultrasound assessment of patients with shock, major trauma, chest pain or breathlessness in emergency ambulances. Five Highland Scottish Ambulance Service ambulances will be equipped with an ultrasound machine and satellite/cellular transmission system plus webcam, and will be deployed in real emergency situations. Our previous SURS project demonstrated that individuals with no prior ultrasound scanning experience and only 20 minutes of training can complete Focused Assessment with Sonography in Trauma (FAST) scans successfully and quickly under remote direction from an Emergency Physician. The scans take less than 5 minutes and will be transmitted to a hospital-based expert for review, providing support and instructions for optimal prehospital care. We also aim to assess the use of prehospital ultrasound in fracture and stroke assessment, comparing it with standard imaging modalities.
We will examine the remotely supported prehospital ultrasound implementation in terms of its delivery and functioning. An economic evaluation will compare its use with care as usual for eligible patients transported by ambulance, modelling costs and benefits of service expansion and determining optimum use.
Link:
Funders:
- European Space Research and Technology Centre
- ARTES 3-4: Telecom - Products Programme
Project Partners:
Lead:
- ViaSat Antenna Systems S.A.
Other partners:
- ViaSat UK
- Zebra Academy CVBA (SME)
Research Collaborators:
- Scottish Ambulance Service
- NHS Highland
Papers:
Champagne N, Eadie L, Regan L, Wilson P. The effectiveness of ultrasound in the detection of fractures in adults with suspected upper or lower limb injury: A Systematic Review and Subgroup Meta-Analysis. BMC Emergency Medicine 2019, 19:17. https://rdcu.be/biYie
Marsh-Feiley G, Eadie L, Wilson P. Telesonography in emergency medicine: A systematic review. PLOS ONE 2018;13(5):e0194840. doi: 10.1371/journal.pone.0194840
Eadie L, Mulhern J, Regan L, Mort A, Shannon H, Macaden A, Wilson P. Remotely supported prehospital ultrasound: a feasibility study of real-time image transmission and expert guidance to aid diagnosis in remote and rural communities. Journal of Telemedicine and Telecare 2017 24 (9): 616-622 https://doi.org/10.1177/1357633X17731444 (http://journals.sagepub.com/eprint/WK2n8NeAbgu7jZUuYi4v/full)
Mort A, Eadie L, Regan L, Macaden A, Heaney D, Bouamrane MM, Rushworth G, Wilson P. Combining transcranial ultrasound with intelligent communication methods to enhance the remote assessment and management of stroke patients: Framework for a technology demonstrator. Health Informatics Journal. 2016;22(3):691-701. doi: 0.1177/1460458215580353
Eadie LH, Mort A, Regan L, MacAden AS, Wilson P. Remotely Supported Prehospital Ultrasound: Real-Time Communication Technology for Remote and Rural Communities. Journal of International Society for Telemedicine and eHealth (Russian). 2016 1: 54-57.
Eadie L, Regan L, Mort A, Shannon H, Walker J, MacAden A, Wilson P. Telestroke assessment on the move: pre-hospital streamlining of patient pathways. Stroke 2015;46:e38-e40. DOI: 10.1161/STROKEAHA.114.007475