Telemedicine and Recreation, MD Eliya Kostova. Varna Startup Health Tech Week...
Telemedicine in emergencies and disasters
1. First Young Neurosurgeons Forum
quarterly online symposium
29th January , 2011
Muhammad Raji Mahmud, MD, FWACS
Chair, Young Neurosurgeons Forum of the World Federation of Neurosurgical Societies (WFNS)
Neurosurgical Service for Disasters:
Telemedicine/Telesurgery & the Mobile
Emergency/Neurosurgical Unit (MEU/MNU)
Concept
2. Neurosurgical Service for Disasters:
Telemedicine/Telesurgery & the Mobile
Emergency/Neurosurgical Unit (MEU/MNU)
Concept
Speakers
• Prof. Dr. Leónidas Quintana, WFNS 2nd Vice President
• Prof. Dr. Russell Andrews, WFNS Education & Training
Committee
• Prof. Dr. Yoko Kato, WFNS Education & Training
Committee Chair
• Dr. Ganesalingam Narenthiran, Chairman of the
Neurological Surgery Research List Serv. On line .
3. World Federation of Neurosurgical Societies
Mission Statement
• To facilitate the personal association of neurological surgeons
throughout the world.
• To aid in the exchange and dissemination of knowledge and
ideas in the field of neurological surgery.
• To encourage research in neurological surgery and allied sciences.
• To address issues of neurosurgical demography.
• To address issues of Public Health.
• To implement, improve and promote the standards of
neurosurgical care and training worldwide.
4. World Federation of Neurosurgical Societies
Main Priorities
• Training of neurosurgeons from developing areas, both with Educational Courses
in different countries and with grants to enable them to train at selected
neurosurgical centers in different parts of the world.
• Donation of instruments and equipment and the necessary technical advice to
implement them in the neurosurgical units in economically challenged regions.
• Priority to public health issues: prevention & treatment of head injuries & spinal
trauma, vascular pathology with special attention to the elderly, treatment of
degenerative diseases, prevention of developmental & neonatal malformations.
• Research in neurosurgical subspecialties, such as brain tumours, vascular
pathologies and degenerative diseases.
• The assessment and introduction of new technologies.
• A forum for young neurosurgeons.
• Maintenance of a Website which addresses neurosurgical interests of physicians,
corporations, and the general public.
5. SOME BACKGROUND OF THIS CONFERENCE…..
Personal report against AC WFNS – Nyon, Switzerland,
February 27th , 2010 - Humanitarian Assistance to Undeveloped Countries
A serious matter is Haiti , this country isn´t federated to FLANC, this society is
affiliated to the Caribbean Society of Neurosurgery,but in this country,
the social- economical situation is extremely bad.
My proposal is we could form a team, of humanitarian assistance , included our
specialty of course,and the sequence to act , could be:
1- First to contact some representative of this country ( administrative,Health Ministry,
or Government), to offer and give our assistance as a team.
2-In the near future, when we could have more information of the real health situation
related with our specialty,
3- Contact the authorities, and we could propose to travel with instruments
promoted by the WFNS,and give our assistance.
4-If it´s needed, the team could stay some time, eg: 1 or 2 months, operate some
urgent cases, and give, as a donation, the instruments to some public hospital,and designate
some colleague(s) that be our representative, and be responsible of the instruments. Consider
the Mobile Emergency Unit (MEU).
5-Later, we could monitor the neurosurgical actions and activities at this country.
6. The same day of my report, this was happening in my country……
Chile
7. The same day of my report, this was happening in my country……
Chile EQ 8.8 Richter
8. What´s happening in some parts of our planet ???
Source: http://neic.cr.usgs.gov/neis/eqlists/eqstats.html
9. 2010 -Two big earthquakes happened in America
Haiti- A country with a very weak social economical situation, and health system not well
organized. EQ Magnitude 7.0 - HAITI REGION 2010 January 12 21:53:10 UTC - 04:53:10 PM at
epicenter
According to official estimates, 222,570 people killed, 300,000 injured, 1.3 million displaced,
97,294 houses destroyed and 188,383 damaged in the Port-au-Prince area and in much of southern Haiti.
This includes at least 4 people killed by a local tsunami in the Petit Paradis area near Leogane.
10. 2010 -Two big earthquakes in America happened
Chile- A country with a middle high social economical situation(WDB), and health system well
organized. EQ Magnitude 8.8 - OFFSHORE MAULE, CHILE 2010 February 27 06:34:14 UTC
- 03:34:14 AM at epicenter.
At least 521 people killed, 56 missing, about 12,000 injured,
800,000 displaced and at least 370,000 houses, 4,013 schools,
79 hospitals and 4,200 boats damaged or destroyed by the earthquake
and tsunami in the Valparaiso-Concepcion-Temuco area.
At least 1.8 million people affected in Araucania,
Bio-Bio, Maule, O'Higgins, Region Metropolitana
and Valparaiso.
The total economic loss in Chile was estimated at 30
billion US dollars.
Electricity, telecommunications and water supplies
were disrupted and the airports at Concepcion and
Santiago had minor damage.
The tsunami damaged or destroyed many buildings
and roads at Concepcion, Constitucion, Dichato and
Pichilemu
11. Emergencies in Disasters
What is the real situation in these Disasters?
Isolation , all is dark during night , the land
continuously moving….you can feel the destruction
Communications fail
Prompt action in the devastated places difficult
Health care difficult to perform
Traumatic cases increase
Also , another pathologies
13. The World Health Organization defined Telemedicine (TM) as
the use in the clinic of the medical knowledge, through
communication networks when the distance is a determining factor.
This definition makes clear the need for the use of advanced
technological support for the practice of medicine has no distance
limitations for the patient.
The technology infrastructure allows to perform the exchange of
information between various participants involved in an act of TM
and its main objective is to provide multimedia network services
(transfer of audio, video, images, data and text) that enable healthcare
14. Telemedicine can be broken into three main categories:
1- Store-and-forward
2-Remote monitoring
3-Interactive services
15. 1-Store-and-forward Telemedicine
It involves acquiring medical data (like medical images, biosignals etc)
and then transmitting this data to a doctor or medical specialist at a
convenient time for assessment offline.
It does not require the presence of both parties at the same time.
2- Remote Monitoring
Also known as self-monitoring or testing, enables medical professionals
to monitor a patient remotely using various technological devices.
3-Interactive Telemedicine Services
Provide real-time interactions between patient and provider, to include
phone conversations, online communication and home visits.
In addition, “clinician-interactive” telemedicine services may be less
costly than in-person clinical visits.
16. How we could improve the healthcares during a
DISASTER ???
Mainly treating some urgent problems as:
1- Quick communication with the area or region of the
Disaster ( Diagnosis of the situation).(Satellital, IP telephony)
(Physically by helicopters)
2- Quick access with medical cares, essentially, for urgent
cases( Trauma). Mobile Emergency Unit (MEU)
3- Treat and compensation of clinical cases in the area
affected.(*)
4- Maintain the communication with the general medical
doctor ( surgeon), to give more indications from the base
hospital.(Telepresence)
5- Triage of the affected cases to the base hospital.
SAP <90mmHg
HBO2sat <90%
PaO2 < 60 mm Hg
(*)
17.
18. Chilean communication network
developed by the Health
Ministry cover all the country
from the northern region to the
southern region of the south
american continent, and the
Antartida, including Easter Is.
(Rapa Nui), and Robinson
Crusoe group of Islands. to the
West , in the Pacific ocean.
Each region has a base hospital
and the metropolitan region
(Santiago , the capital)
has 4 base hospitals and one
Central Hospital only for
Emergencies
23. Robotic op.
Operating room
Laboratory –X Ray -CT Scan
Robotized Camera assistance
Sensors devices
Telepresence
24. A final and important message ……
The countries of the world under developing social-economical
status must continue to seek ways to meet the basic needs of
their populations, through nutrition and sanitation programs,
poverty reduction, universal quality education, and economic
modernization.
At the same time, they must do their part to address global
challenges.
In such a context, leveraging the opportunities presented by
technological change in a globalized economy becomes a
necessity for any emerging economy.
