title: The use of telemedicine for real-time video consultation between trauma center and community hospital in a rural setting improves early trauma care: preliminary results.
abstract: BACKGROUND
  By geographic necessity, rural trauma patients must be initially stabilized at local community hospitals before transfer for definitive care. In this study, it was hypothesized that telemedicine consults with trauma surgeons from a Level I trauma center online while the patient was still in the community hospital ED could positively affect care.
  
  
  METHODS
  Four community hospital emergency departments in upstate New York and Vermont were equipped with dual cameras with remote control capability. Three trauma surgeons' homes were wired and equipped with telemedicine systems. Protocols were developed for the initiation of a telemedicine consult.
  
  
  RESULTS
  There were 26 telemedicine consults over an 8-month period. The telemedicine population was significantly more severely injured and had a higher mortality than the general trauma population admitted to the Level I trauma center. In two cases, it was felt that the telemedicine consultation was potentially lifesaving. On follow-up, more than 80% of the referring providers felt that the telemedicine consult improved care.
  
  
  CONCLUSIONS
  Telemedicine provides a virtual online trauma surgeon to assist with the resuscitation and stabilization of the major trauma patient in a small community hospital. These preliminary results show a positive impact on rural trauma patient care at the local community hospital.
authors.affiliation: Department of Surgery, Fletcher Allen Health Care, University of Vermont, Burlington, Vermont 05401, USA. frederick.rogers@vtmednet.org
authors.forename: F B
authors.initials: FB
authors.lastname: Rogers
authors.forename: M
authors.initials: M
authors.lastname: Ricci
authors.forename: M
authors.initials: M
authors.lastname: Caputo
authors.forename: S
authors.initials: S
authors.lastname: Shackford
authors.forename: K
authors.initials: K
authors.lastname: Sartorelli
authors.forename: P
authors.initials: P
authors.lastname: Callas
authors.forename: J
authors.initials: J
authors.lastname: Dewell
authors.forename: S
authors.initials: S
authors.lastname: Daye
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004636:Emergency Service, Hospital; D004638:Emergency Treatment / Q000592:standards*; D005260:Female; D006764:Hospitals, Community; D006801:Humans; D008297:Male; D008875:Middle Aged; D009518:New York; D019114:Remote Consultation / Q000592:standards*; D012423:Rural Health; D011795:Surveys and Questionnaires; D014193:Trauma Centers; D014707:Vermont; D014743:Videotape Recording; D014947:Wounds and Injuries / Q000628:therapy*