Müller Anna, Arimond Robert, Kunczik Janosch, Rossaint Rolf, Czaplik Michael, Follmann Andreas
Faculty of Medicine, RWTH Aachen University, Aachen 52074, Germany.
Docs in Clouds Telecare GmbH, Aachen 52074, Germany.
World J Emerg Med. 2025;16(2):121-128. doi: 10.5847/wjem.j.1920-8642.2025.027.
As disasters intensify and professional deficits persist, civil protection is reliant on medical volunteers. With limited physician availability, telemedicine is promising. No system currently empowers lower-qualified paramedics for physician-delegated telemedicine. Existing telemedicine technology unfits for civil protection. This study aimed to evaluate a modified system at a music festival to simulate disaster situations.
A tablet-based telemedicine system, integrating vital sign monitoring, was deployed at the "Summerjam" music festival characterized by various medical emergencies. A physician could be contacted via telemedicine or requested onsite. Medical feasibility was rated by patient condition changes, with National Advisory Committee of Aeronautics (NACA) score and Primary Ranking for Initial Orientation in the Rescue service (PRIOR) algorithm for triaging. Technical feasibility was assessed by connection stability, communication, and vital sign transmission.
Of 404 treatments, 34 (8.4%) were performed using telemedicine, 49 (12.1%) were carried out with a physician onsite. Telemedicine treatments accounted for 40.9% of all treatment in which a physician was involved. Patient conditions varied up to NACA III (moderate disturbance). A variety of internal medical (76.5%) and surgical (23.5%) conditions were addressed, some of which required invasive measures or application of medication. No patients experienced a deterioration in their condition. Despite technical difficulties, treatment was not significantly impacted, confirming technical feasibility.
The study shows that lower-qualified paramedics can effectively use telemedicine for physician-delegated treatment, suggesting potential applicability to civil protection. Nonetheless, further system robustness improvements and research are needed.
随着灾害加剧且专业人员短缺问题持续存在，民防工作依赖于医疗志愿者。由于可用医生数量有限，远程医疗前景广阔。目前尚无系统能让资质较低的护理人员开展医生授权的远程医疗。现有的远程医疗技术不适用于民防。本研究旨在评估在音乐节模拟灾害情况下的改良系统。
在以各种医疗紧急情况为特征的“夏日音乐节”上部署了一个集成生命体征监测功能的基于平板电脑的远程医疗系统。可通过远程医疗联系医生或要求医生到现场。根据患者病情变化评估医疗可行性，采用美国国家航空咨询委员会（NACA）评分和救援服务初始定向主要分级（PRIOR）算法进行分诊。通过连接稳定性、通信和生命体征传输评估技术可行性。
在404例治疗中，34例（8.4%）通过远程医疗进行，49例（12.1%）由现场医生进行。远程医疗治疗占所有涉及医生的治疗的40.9%。患者病情变化至NACA III级（中度干扰）。处理了各种内科（76.5%）和外科（23.5%）疾病，其中一些需要采取侵入性措施或用药。没有患者病情恶化。尽管存在技术困难，但治疗未受到显著影响，证实了技术可行性。
该研究表明，资质较低的护理人员可有效利用远程医疗进行医生授权的治疗，表明其在民防方面具有潜在适用性。尽管如此，仍需要进一步提高系统的稳健性并开展研究。
