Digital health Emergency care by tele-emergency doctors

In medical emergencies, every second often counts when it comes to saving lives or avoiding permanent damage. However, emergency doctors are unable to quickly reach medical scenes in all regions. Telemedicine can be used to improve patient care in emergencies. To that end, tele-emergency doctors in control centers support the emergency responders at the scene. They help make diagnoses and direct the treatment remotely. As a result, appropriate care can be provided in many emergencies, such as blood pressure derailments, with the support of a tele-emergency doctor.

When an ambulance is sent to an emergency, there is often no doctor on board. The control center uses the caller’s information to determine whether to request an emergency doctor in addition to the paramedics. The emergency doctor drives to the scene independently of the ambulance and often arrives later. In many situations, it can also be useful for a tele-emergency doctor to remotely support the emergency responders at the scene.

In Germany, paramedics have limited powers to treat patients and administer medication. By involving a tele-emergency doctor, the emergency situation can be assessed and the necessary treatment can be provided quickly and safely. The tele-emergency doctor is responsible for the treatment initiated.

In rural regions, there are often only a few emergency medical centers, which have to cover large areas. The traffic situation in micro-spaces within urban areas can also restrict the accessibility of emergency scenes. To nevertheless enable rapid medical assessments and treatments in emergencies, a growing number of municipalities are using tele-emergency doctors to support the conventional emergency services.

Tele-emergency doctors provide the emergency responders at the scene with remote medical and organizational support. They are connected to the ambulance by a live feed. The emergency responders can give tele-emergency doctors important information and data about patients’ blood pressure, heart function (ECG) and breathing. This cooperation enables the tele-emergency doctor to provide the emergency responders at the scene with advice and guidance as they assess the emergency situation and instigate treatment.

What are the duties of a tele-emergency doctor?

The main duties of a tele-emergency doctor include offering advice and guidance to the emergency responders at the scene. Tele-emergency doctors can:

• help make diagnoses
• approve treatments, such as the administration of medication
• retrospectively order an emergency doctor to the scene if required (in consultation with the emergency services)
• assist the emergency doctor at the scene with decisions
• notify the hospital of a patient’s arrival
• provide advice and support during onward transportation and patient transfers to another hospital

In emergencies where there is no acute risk to life, the main roles of an emergency doctor include providing a medical assessment, prescribing treatments, for example by administering medication, or deciding whether a patient should be transported to the hospital. These tasks can also be performed by tele-emergency doctors. Tele-emergency doctors can provide support in the following situations, for example:

• blood pressure derailments
• hypoglycemia
• pain management for non-life-threatening injuries
• strokes not involving a loss of consciousness

Studies and the experience gained from medical care to date have shown that tele-emergency doctors are able to provide the same (if not a better) level of medical care for non-life-threatening emergencies as emergency doctors at the scene.

Tele-emergency doctors are experienced, specially trained medical practitioners. Prior to working as a tele-emergency doctor, a doctor must have attended more than 500 emergencies in person and acquired additional qualifications in emergency medicine. Doctors are appropriately trained before they can work as tele-emergency doctors.