遠距醫療於緊急醫療之運用

Telemedicine in Emergent Service

遠距醫療的精神為透過資訊及電信通訊技術來交換相隔兩地的病患的相關醫療臨床資訊，並且提供一平台予醫療專家交換意見，進行診斷；此技術克服空間甚至時間上的障礙，同時結合了電腦、電信通信技術與醫療人員的專業知識；遠距醫療之優點，達到打破時空限制和資源分享，節省成本之目的。在緊急醫療服務架構下，遠距醫療快速傳輸的特點，正好能夠對需要緊急照護病人爭取診療時效；藉由遠距醫療提供的平台，將醫師和護理人員的專業知識透過遠距傳輸架構，提供給患者以及家屬即時的醫療服務與顧問；而在無遠弗屆的網路世界中，醫師可透過視訊系統、遠距教學以及隔空會診等功能，指導救護技術員對傷病患進行相關的到院前緊急救護處置。本文中我們提出一個引進當前遠距醫療中會診、教學提供、轉診的強大功能，結合緊急救護網內的緊急醫療資源管理系統、救護車動態管理系統，以及全球衛星定位系統等先進科技，打造一套完整的緊急救護體系。透過這樣的資訊匯流模式，將會更有效的整合區域內醫療院所的資源，使區域內的「緊急醫療救護中心」發揮及時搶救與提高病患診治先機的功能，提昇緊急醫療品質，均衡醫療資源，以保障國民健康為目標。

In this review article we describe how advanced telemedicine technology can transfer medical knowledge, consulting, and remote medical procedures or examinations in emergent medical services. Technically, telemedicine combines the information technology, videoconference equipment, and medical expertise to conduct a real-time consultation scenario for non-professional personnel undergoing pre-hospital resuscitation in a cost-effective manner. Telecommunication with an on-line medical expertise through audiovisual media is particularly useful in rural area where timely transport to adequate medical facilities is impossible. Equipped with ample bandwidth of transmission, the onsite personnel in charge of the pre-hospital resuscitation can share the hand-on physical examination, EKG, ultrasound image, and vital signs with the emergent medical experts away from the field. Thus, the remote attending physician can access an exact critical status to prepare for adequate medication and intervention upon victim’s arrival without delay. The surge of patient-centered medicine of in-hospital care standard strongly favors a wider implementation of videoconferencing, intelligent emergency care decision support system, and GPS system into the modern pre-hospital care system. We expect that each patient undergoing pre-hospital resuscitation will soon benefit from a real-time professional practice through the comprehensive telemedicine technology.