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[术前评估与知情同意的远程会诊——我们是否准备好迎接范式转变?]

[Teleconsultation for preoperative evaluation and informed consent-Are we ready for a paradigm shift?].

作者信息

Wienhold Jan, Kemper Ilka, Czaplik Michael, Follmann Andreas, Rossaint Rolf, Derwall Matthias

机构信息

Klinik für Anästhesiologie, Medizinische Fakultät der RWTH Aachen, Uniklinik RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Deutschland.

Geschäftsbereich Recht, Uniklinik RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Deutschland.

出版信息

Anaesthesiologie. 2023 Oct;72(10):697-702. doi: 10.1007/s00101-023-01319-8. Epub 2023 Aug 10.

DOI:10.1007/s00101-023-01319-8
PMID:37563314
Abstract

In Germany, approximately 17 million anaesthesiological procedures and, consequently, roughly the same number of preoperative consultations are conducted each year. So far, these have predominantly taken place in person. However, recent developments in technology, medical-legal aspects, and politics, combined with the catalyzing effect of the pandemic situation, have led to a significant boost in telemedicine. In the field of anaesthesia, there are new approaches to implementing telemedicine in the pre- and postoperative setting. This article focuses on the preoperative setting and presents general requirements for a teleconsultation as preoperative evaluation, the current state of technology, and medical-legal aspects.

摘要

在德国,每年大约进行1700万例麻醉手术,因此术前会诊的数量大致相同。到目前为止,这些会诊主要是面对面进行的。然而,技术、医疗法律方面和政治领域的最新发展,再加上疫情形势的催化作用,推动了远程医疗的显著发展。在麻醉领域,术前和术后阶段实施远程医疗有了新方法。本文重点关注术前阶段,介绍术前评估远程会诊的一般要求、技术现状以及医疗法律方面的情况。

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本文引用的文献

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Assessment of the reliability of virtual preanesthetic airway evaluation compared to traditional in-person airway evaluation: a prospective observational study.评估虚拟麻醉前气道评估与传统面对面气道评估的可靠性:一项前瞻性观察研究。
Can J Anaesth. 2023 Jan;70(1):79-86. doi: 10.1007/s12630-022-02345-7. Epub 2022 Nov 14.
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Smartphone detection of atrial fibrillation using photoplethysmography: a systematic review and meta-analysis.使用光电容积脉搏波描记法通过智能手机检测心房颤动:一项系统评价和荟萃分析。
Heart. 2022 Sep 26;108(20):1600-1607. doi: 10.1136/heartjnl-2021-320417.
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A Comparative Study to Evaluate the Efficacy of Virtual Versus Direct Airway Assessment in the Preoperative Period in Patients Presenting for Neurosurgery: A Quest for Safer Preoperative Practice in Neuroanesthesia in the Backdrop of the COVID-19 Pandemic!
一项比较研究:评估神经外科手术患者术前虚拟气道评估与直接气道评估的效果——在新冠疫情背景下寻求神经麻醉更安全的术前操作!
J Neurosci Rural Pract. 2021 Sep 28;12(4):718-725. doi: 10.1055/s-0041-1735824. eCollection 2021 Oct.
4
Teleconsultation for preoperative evaluation during the coronavirus disease 2019 pandemic: A technical and medical feasibility study.新型冠状病毒肺炎疫情期间的术前评估远程会诊:一项技术和医学可行性研究。
Eur J Anaesthesiol. 2021 Dec 1;38(12):1284-1292. doi: 10.1097/EJA.0000000000001616.
5
Virtual preoperative assessment in surgical patients: A systematic review and meta-analysis.虚拟术前评估在外科手术患者中的应用:系统评价和荟萃分析。
J Clin Anesth. 2021 Dec;75:110540. doi: 10.1016/j.jclinane.2021.110540. Epub 2021 Oct 11.
6
A Retrospective Analysis of Patients Undergoing Telemedicine Evaluation in the PreAnesthesia Testing Clinic at H. Lee Moffitt Cancer Center.H. Lee Moffitt 癌症中心麻醉前测试诊所有史以来接受远程医疗评估的患者回顾性分析。
Cancer Control. 2021 Jan-Dec;28:10732748211044347. doi: 10.1177/10732748211044347.
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Smartphone based blood pressure measurement: accuracy of the OptiBP mobile application according to the AAMI/ESH/ISO universal validation protocol.基于智能手机的血压测量:OptiBP 移动应用程序根据 AAMI/ESH/ISO 通用验证协议的准确性。
Blood Press Monit. 2021 Dec 1;26(6):441-448. doi: 10.1097/MBP.0000000000000556.
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Smartphone Biosensor With App Meets FDA/ISO Standards for Clinical Pulse Oximetry and Can Be Reliably Used by a Wide Range of Patients.具有应用程序的智能手机生物传感器符合 FDA/ISO 临床脉搏血氧饱和度标准,可被广泛的患者可靠使用。
Chest. 2021 Feb;159(2):724-732. doi: 10.1016/j.chest.2020.08.2104. Epub 2020 Sep 11.
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Circ Cardiovasc Imaging. 2019 Aug;12(8):e008857. doi: 10.1161/CIRCIMAGING.119.008857. Epub 2019 Aug 6.