Telemedicine shows promise for improving emergency response during trauma, disasters and other chaotic situations. It allows remote experts to assist on-site healthcare providers in real-time. Studies have demonstrated its safety and cost-effectiveness. However, telemedicine is still vastly underutilized for these situations due to lack of infrastructure, policies, protocols and standards. Ongoing work is being done to establish these frameworks and continue demonstrating telemedicine's ability to save lives in extreme conditions around the world. With further development, telemedicine could transform emergency response for both rural and disaster settings.