Application of Telemedicine in the Ambulance for Stroke Patients: A Systematic Review

Sarpourian, Fatemeh; Ahmadi Marzaleh, Milad; Fatemi Aghda, Seyed Ali; Zare, Zahra

doi:10.1017/s1049023x23006519

Cited by 3 publications

(1 citation statement)

References 42 publications

(131 reference statements)

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“…Similarly, prehospital evaluation of stroke patients has been practiced for several years. A systematic review of the use of telemedicine in ambulances for stroke patients demonstrated feasibility, reliability, and accuracy in neurological evaluations through telemedicine [35].…”

Section: Telemedicine and Icu Care Outside The Icumentioning

confidence: 99%

Telemedicine for emergency patient rescue

Subramanian,

Pamplin

2024

Current Opinion in Critical Care

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Purpose of review This article summarizes recent developments in the application of telemedicine, specifically tele-critical care (TCC), toward enhancing patient care during various types of emergencies and patient rescue scenarios when there are limited resources in terms of staff expertise (i.e., knowledge, skills, and abilities), staffing numbers, space, and supplies due to patient location (e.g., a non-ICU bed, the emergency department, a rural hospital) or patient volume as in pandemic surges. Recent findings The COVID-19 pandemic demonstrated the need for rapidly scalable and agile healthcare delivery systems. During the pandemic, clinicians and hospital systems adopted telemedicine for various applications. Taking advantage of technological improvements in cellular networks and personal mobile devices, and despite the limited outcomes literature to support its use, telemedicine was rapidly adopted to address the fundamental challenge of exposure in outpatient settings, emergency departments, patient follow-up, and home-based monitoring. A critical recognition was that the modality of care (e.g., remote vs. in-person) was less important than access to care, regardless of the patient outcomes. This fundamental shift, facilitated by policies that followed emergency declarations, provided an opportunity to maintain and, in many cases, expand and improve clinical practices and hospital systems by bringing expertise to the patient rather than the patient to the expertise. In addition to using telemedicine to maintain patient access to healthcare, TCC was harnessed to provide local clinicians, forced to manage critically ill patients beyond their normal scope of practice or experience, access to remote expertise (physician, nursing, respiratory therapist, pharmacist). These practices supported decades of literature from the telemedicine community describing the effectiveness of telemedicine in improving patient care and the many challenges defining its value. Summary In this review, we summarize numerous examples of innovative care delivery systems that have utilized telemedicine, focusing on ‘mobile’ TCC technology solutions to effectively deliver the best care to the patient regardless of patient location. We emphasize how a ‘paradigm of better’ can enhance the entirety of the healthcare system.

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Section: Telemedicine and Icu Care Outside The Icumentioning

confidence: 99%

Telemedicine for emergency patient rescue

Subramanian,

Pamplin

2024

Current Opinion in Critical Care

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Tele-Critical Care Support Outside the Intensive Care Unit

Siner

2024

Critical Care Clinics

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Effect of telemedicine on wound-related and patient-reported outcomes in chronic wound patients: A systematic review and meta-analysis (Preprint)

Zhang,

Guo,

Duan

et al. 2024

Preprint

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BACKGROUND Telemedicine (TM) may bring new vitality and opportunities to the field of wound care and has been advocated as a potential and feasible strategy for chronic wound management. OBJECTIVE This systematic review and meta-analysis aimed to assess the effectiveness of TM on wound-related outcomes and patient-reported outcomes (PROs) in patients with chronic wounds. METHODS A comprehensive search of nine databases—PubMed, Embase, PsycINFO, Cochrane Library, CINAHL, Web of Science, China National Knowledge Infrastructure database, Wanfang Database, and VIP Database—was performed to identify eligible randomized controlled trials (RCTs) that investigated the effectiveness of TM for patients with chronic wounds. Two reviewers independently conducted the study selection, data extraction, risk of bias assessment, and evaluation of evidence quality. Meta-analyses were performed where feasible; otherwise, narrative summaries were provided. RESULTS A total of 22 RCTs involving 2370 participants met the inclusion criteria. Overall, the utilization of TM significantly improved the healing rate, healing score, healing time, amputation rate, pain, and quality of life of chronic wound patients. However, no significant differences in mortality, depression, anxiety, or patient satisfaction were observed. Furthermore, the subgroup analyses revealed significant effects in TM of short-term, for pressure injuries and venous ulcers, as well as TM in conjunction with a face-to-face component on improvements to the healing rate. The subgroup analyses showed a significant decrease in healing time with TM for venous ulcers or in conjunction with a face-to-face component. The subgroup analyses also indicated significant effects of TM with ≥ 2 types, for diabetes foot ulcers, in conjunction with a face-to-face component, or in combination with communication components in improving the amputation rate. Therefore, TM appears to be an effective method for chronic wound management. CONCLUSIONS A total of 22 RCTs involving 2370 participants met the inclusion criteria. Overall, the utilization of TM significantly improved the healing rate, healing score, healing time, amputation rate, pain, and quality of life of chronic wound patients. However, no significant differences in mortality, depression, anxiety, or patient satisfaction were observed. Furthermore, the subgroup analyses revealed significant effects in TM of short-term, for pressure injuries and venous ulcers, as well as TM in conjunction with a face-to-face component on improvements to the healing rate. The subgroup analyses showed a significant decrease in healing time with TM for venous ulcers or in conjunction with a face-to-face component. The subgroup analyses also indicated significant effects of TM with ≥ 2 types, for diabetes foot ulcers, in conjunction with a face-to-face component, or in combination with communication components in improving the amputation rate. Therefore, TM appears to be an effective method for chronic wound management. CLINICALTRIAL CRD42023462475

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Application of Telemedicine in the Ambulance for Stroke Patients: A Systematic Review

Cited by 3 publications

References 42 publications

Telemedicine for emergency patient rescue

Telemedicine for emergency patient rescue

Tele-Critical Care Support Outside the Intensive Care Unit

Effect of telemedicine on wound-related and patient-reported outcomes in chronic wound patients: A systematic review and meta-analysis (Preprint)

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