Amadi-Obi Ahjoku, Gilligan Peadar, Owens Niall, O'Donnell Cathal
Clinical Research Department, Royal College of Surgeons in Ireland, 123 St. Stephen's Green, Dublin 2, Ireland ; Emergency Department, Beaumont Hospital, Beaumont, Dublin 9, Ireland.
Emergency Department, Beaumont Hospital, Beaumont, Dublin 9, Ireland.
Int J Emerg Med. 2014 Jul 5;7:29. doi: 10.1186/s12245-014-0029-0. eCollection 2014.
The right person in the right place and at the right time is not always possible; telemedicine offers the potential to give audio and visual access to the appropriate clinician for patients. Advances in information and communication technology (ICT) in the area of video-to-video communication have led to growth in telemedicine applications in recent years. For these advances to be properly integrated into healthcare delivery, a regulatory framework, supported by definitive high-quality research, should be developed. Telemedicine is well suited to extending the reach of specialist services particularly in the pre-hospital care of acute emergencies where treatment delays may affect clinical outcome. The exponential growth in research and development in telemedicine has led to improvements in clinical outcomes in emergency medical care. This review is part of the LiveCity project to examine the history and existing applications of telemedicine in the pre-hospital environment. A search of electronic databases including Medline, Excerpta Medica Database (EMBASE), Cochrane, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) for relevant papers was performed. All studies addressing the use of telemedicine in emergency medical or pre-hospital care setting were included. Out of a total of 1,279 articles reviewed, 39 met the inclusion criteria and were critically analysed. A majority of the studies were on stroke management. The studies suggested that overall, telemedicine had a positive impact on emergency medical care. It improved the pre-hospital diagnosis of stroke and myocardial infarction and enhanced the supervision of delivery of tissue thromboplasminogen activator in acute ischaemic stroke. Telemedicine presents an opportunity to enhance patient management. There are as yet few definitive studies that have demonstrated whether it had an effect on clinical outcome.
在合适的时间、合适的地点找到合适的人并非总是可行的；远程医疗为患者提供了与合适的临床医生进行音频和视频交流的可能性。近年来，视频对视频通信领域的信息和通信技术（ICT）进步推动了远程医疗应用的增长。为了将这些进步妥善融入医疗服务中，应制定一个由高质量权威研究支持的监管框架。远程医疗非常适合扩大专科服务的覆盖范围，特别是在急性紧急情况的院前护理中，因为治疗延迟可能会影响临床结果。远程医疗研发的指数级增长已使急诊医疗的临床结果得到改善。本综述是LiveCity项目的一部分，旨在研究远程医疗在院前环境中的历史和现有应用。我们检索了包括Medline、医学文摘数据库（EMBASE）、Cochrane以及护理学与健康相关文献累积索引（CINAHL）在内的电子数据库，以查找相关论文。纳入了所有涉及在急诊医疗或院前护理环境中使用远程医疗的研究。在总共1279篇被审查的文章中，39篇符合纳入标准并进行了严格分析。大多数研究是关于中风管理的。研究表明，总体而言，远程医疗对急诊医疗有积极影响。它改善了中风和心肌梗死的院前诊断，并加强了急性缺血性中风中组织纤溶酶原激活剂给药的监督。远程医疗为加强患者管理提供了一个机会。目前很少有确凿的研究表明它是否对临床结果有影响。
