A comprehensive telemedicine system for remote guidance of emergency airway management

Abstract

We developed a Tele-Airway Management System (TAMS) which contained two high quality videocameras which were set up to view the frontal and lateral parts of the patient. Another endoscopic camera, a videolaryngoscope, was used to view the anatomy of the airway. One patient monitor was used to view the vital signs and there was also a PC terminal. A study was conducted in two separate emergency departments with 33 novice intubators (medical students and interns of the department). Remote consultation was provided by a board certified emergency physician. The time taken to complete endotracheal intubation for the TAMS group was 82.1 s (SE 4.9) and was 103.8 s (SE 7.9) in the videolaryngoscope-only group. The difference was significant (P = 0.03). The success rate of endotracheal intubation within 2 min was 94% for the TAMS group and 63% in the videolaryngoscope-only group (P = 0.04). With a wireless communication system, the TAMS could be installed in an ambulance, which might allow paramedics to perform safe and effective airway management in the field.