Abstract 76: Testing the Feasibility of Using Telemedicine for Post-Cardiac Arrest Management in the Emergency Department
Objectives: Dissemination and implementation of post-cardiac arrest care (i.e. targeted temperature management [TTM]) has lagged across the US, and access to centers capable of delivering TTM remains limited. Telemedicine has been utilized for time sensitive conditions (acute ischemic stroke) and may provide a means for expanding clinical expertise. We sought to test the practical and technological feasibility of using emergency department (ED) based telemedicine to manage return of spontaneous circulation (ROSC) after OHCA including induction of TTM.
Methods: We created a hub-spoke telemedical network between an academic level I trauma center and two affiliated EDs - each with a telemedical cart equipped with a HD-video camera, speaker, and microphone. Text- alerts notified the on-call telemedical team of OHCA in the ED. The on-call physician connected via an Internet ready laptop with the ability to: control the ED cart camera, access the EMR, lab values, and radiology images. Consults were monitored to assess connection time and clarity.
Results: Over 12-weeks there were 31 OHCA alerts; 13 achieved ROSC (41.9%), 84.6% of ROSC cases utilized telemedicine; 81.8% were TTM-eligible and 100% of these cases utilized telemedicine. Mean connection time was 3.7 min (3.6 SD); mean duration was 71.7 min (SD 62.7). Mean number of connection attempts was 1.2, with no complete disconnections. Consultants ranked ability to see and hear staff/patients on a Likert scale (5, 4.7 respectively: 5= great). Staff ranked ability to see and hear the telemedical consultant similarly (4.9, 4.8).
Conclusions: This ED-based telemedical pilot demonstrates the practical and technological feasibility of expanding the use of telemedicine to manage and direct protocolized post-cardiac arrest care. This pilot begins to reveal the capability of using telemedicine within the ED for improving the adherence to evidence based protocols for the management of unplanned critical illnesses.
- © 2013 by American Heart Association, Inc.