An assessment of telemedicine possibilities in massive casualties situations.

A Paunksnis, V Barzdziukas, S Kurapkiene, R Vaicaitiene, V Sereika
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Abstract

The use of existing possibilities of Telemedicine Center of Kaunas University of Medicine allows the live distant consultations from high-level medical specialised centers to rural areas. On July 2004 the Telemedicine Center took part in the RESCUER/MEDCEUR project exercise. A special objective was the use of telemedicine facilities for distant consultations and sorting of victims directly at the event place. Telemedicine Center used appropriate telecommunication devices for joint activities of civil and multinational military services in critical situations such as mass casualty events. There were used ISDN lines and IP radio-connection. On the final and most intensive day of the anti-terrorism drills, the multinational force of medics at the Kairiu Training Range in Lithuania reacted to a large mass casualty event--treating hundreds of victims from a simulated train crash. Using on-line telemedicine facilities from Kaunas Medical University Hospital there were corrected the tactics of giving the first help and sorting of casualties. The most complicated initiated cases of eye trauma, neurosurgical trauma, maxilloface trauma and traumatic amputation of limbs evaluated and selected for emergent evacuation to the third level hospitals. All those cases transported to Kaunas and Vilnius Universities Hospitals by helicopters (200 and 300 km from the event place). The common use of existing military and civil telemedicine infrastructure showed the possibilities of interaction in management, giving the first help and sorting of casualties between military and civil medical services during the rescue operations.

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大规模伤亡情况下远程医疗可能性评估。
利用考纳斯医科大学远程医疗中心现有的可能性,可以从高水平的医疗专业中心到农村地区进行远程现场会诊。2004年7月,远程医疗中心参加了RESCUER/MEDCEUR项目演习。一个特别目标是利用远程医疗设施进行远程会诊,并直接在活动地点对受害者进行分类。远程医疗中心在大规模伤亡事件等危急情况下使用适当的电信设备进行民事和多国军事部门的联合活动。有使用的ISDN线路和IP无线连接。在反恐演习的最后一天,也是最紧张的一天,多国医疗部队在立陶宛凯里乌训练场应对了一起大规模伤亡事件——治疗了数百名模拟火车相撞事故的受害者。利用考纳斯医科大学医院的在线远程医疗设施,纠正了急救和伤员分类的策略。对最复杂的眼外伤、神经外科外伤、颌面外伤和外伤性肢体截肢病例进行评估并选择紧急后送至三级医院。所有这些病例都由直升机运送到考纳斯和维尔纽斯大学医院(距离活动地点200公里和300公里)。现有军事和民用远程医疗基础设施的共同使用表明,在救援行动期间,军事和民用医疗服务部门可以在管理、提供第一时间帮助和分类伤亡人员方面进行互动。
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