Experience from Videobased Emergency Medical Interaction
In our experience, the VEMI system has provided a useful tool to improve communication in several emergency situations. For example, a young doctor was assisted by a neurologist in assessing the treatment of refractory epileptic spasms, and a doctor at a municipal casualty clinic could be joined by various specialists at the University Hospital of North Norway in assessing a patient who had suffered burns with potential airway affection. We believe that the choice of appropriate transfer and means of transport can thus be made easier, and in some cases emergency transport by ambulance helicopters has been replaced by transport by ambulance vehicles.
Longyearbyen hospital, Spitsbergen, has used the VEMI system since 2005. This hospital has a limited number of doctors and nurses who perform tasks that on the mainland are presumed to be undertaken by specialists. When several seriously injured patients from a single incident are being admitted, the total resources and capacity of the hospital may prove insufficient. The distance to Tromsø, the nearest city, measures 1 200 km by air, and at best, 7 – 8 hours may pass from the requisition of an ambulance aircraft to the arrival of the patient at the University Hospital of North Norway.
On Friday 5 August 2011, a British group of 13 travellers on a school excursion were attacked without warning by a 250-kilo polar bear near the Van Post Glacier on Spitsbergen. One person was killed and four were seriously injured. All available health personnel had been summoned when the patients arrived at Longyearbyen Hospital: three doctors (one general surgeon and two orthopaedists), three nurse anaesthetists and three operating theatre nurses. The VEMI system was rapidly set up with contact to the Division of Medical Emergency Services in Tromsø. In the VEMI room in Tromsø, participants included on-duty neurosurgeons, a plastic surgeon, an ENT specialist, a thoracic surgeon, a general surgeon, an anaesthesiologist, an intensive-care specialist, an air ambulance doctor, a medical emergency specialist, a radiologist and representatives of the division and hospital administrations. The latter had joined to assess the scope of the accident and the resource needs for the following hours and days. When the patients later arrived at the University Hospital of North Norway, clear plans for each patient had been established on the basis of the VEMI conference. Since the detailed scope of their injuries and the main clinical problems were already known before the pa-tients arrived on the mainland, excessive resource standby, for example in the operating theatres, could be avoided.