Gregory Megan E, Sonesh Shirley C, Hughes Ashley M, Marttos Antonio, Schulman Carl I, Salas Eduardo
Assistant Professor, Department of Biomedical Informatics, The Ohio State University, Columbus, Ohio.
Assistant Professor, Center for the Advancement of Team Science, Analytics and Systems Thinking in Health Services Research (CATALYST), The Ohio State University College of Medicine, Columbus, Ohio.
Disaster Med Public Health Prep. 2021 Apr;15(2):208-215. doi: 10.1017/dmp.2019.156. Epub 2020 Feb 5.
The goal of this study is to test an implementation and examine users' perceptions about the usefulness of telemedicine in mass casualty and disaster settings and to provide recommendations for using telemedicine in these settings.
Ninety-two US Army Forward Surgical Team (FST) members participated in a high-fidelity mass casualty simulation at the Army Trauma Training Center (ATTC). Telemedicine was implemented into this simulation.
Only 10.9% of participants chose to use telemedicine. The most common users were surgeons and nurses. Participants believed it somewhat improved patient care, attainment of expert resources, decision-making, and adaptation, but not the timeliness of patient care. Participants reported several barriers to using telemedicine in the mass casualty setting, including (1) confusion around team roles, (2) time constraints, and (3) difficultly using in the mass casualty setting (eg, due to noise and other conditions).
There appear to be barriers to the use and usefulness of telemedicine in mass casualty and disaster contexts. Recommendations include designating a member to lead the use of telemedicine, providing telemedical resources whose benefits outweigh the perceived cost in lost time, and ensuring telemedicine systems are designed for the conditions inherent to mass casualty and disaster settings.
本研究的目标是测试远程医疗在大规模伤亡和灾难场景中的实施情况，检查用户对其有用性的看法，并为在这些场景中使用远程医疗提供建议。
92名美国陆军前方外科手术小组（FST）成员在陆军创伤培训中心（ATTC）参加了一次高保真大规模伤亡模拟。将远程医疗应用于此次模拟中。
只有10.9%的参与者选择使用远程医疗。最常使用的是外科医生和护士。参与者认为它在一定程度上改善了患者护理、专家资源获取、决策制定和适应性，但没有改善患者护理的及时性。参与者报告了在大规模伤亡场景中使用远程医疗的几个障碍，包括（1）团队角色混乱，（2）时间限制，以及（3）在大规模伤亡场景中使用困难（例如，由于噪音和其他条件）。
在大规模伤亡和灾难情况下，远程医疗的使用和有用性似乎存在障碍。建议包括指定一名成员领导远程医疗的使用，提供其益处超过因时间损失而感知到的成本的远程医疗资源，并确保远程医疗系统针对大规模伤亡和灾难场景固有的条件进行设计。
