Objective: To examine the relationship between pediatric critical care telemedicine consultation to rural emergency departments and triage decisions. We compare the triage location and provider rating of the accuracy of remote assessment for a cohort of patients who receive critical care telemedicine consultations and a similar group of patients receiving telephone consultations.
Design: Retrospective evaluation of consultations occurring between April 2012 and March 2016.
Setting: Pediatric critical care telemedicine and telephone consultations in 52 rural healthcare settings in South Carolina.
Patients: Pediatric patients receiving critical care telemedicine or telephone consultations.
Intervention: Telemedicine consultations.
Measurements And Main Results: Data were collected from the consulting provider for 484 total consultations by telephone or telemedicine. We examined the providers' self-reported assessments about the consultation, decision-making, and triage outcomes. We estimate a logit model to predict triage location as a function of telemedicine consult age and sex. For telemedicine patients, the odds of triage to a non-ICU level of care are 2.55 times larger than the odds for patients receiving telephone consultations (p = 0.0005). Providers rated the accuracy of their assessments higher when consultations were provided via telemedicine. When patients were transferred to a non-ICU location following a telemedicine consultation, providers indicated that the use of telemedicine influenced the triage decision in 95.7% of cases (p < 0.001). For patients transferred to a non-ICU location, an increase in transfers to a higher level of care within 24 hours was not observed.
Conclusion: Pediatric critical care telemedicine consultation to community hospitals is feasible and results in a reduction in PICU admissions. This study demonstrates an improvement in provider-reported accuracy of patient assessment via telemedicine compared with telephone, which may produce a higher comfort level with transporting patients to a lower level of care. Pediatric critical care telemedicine consultations represent a promising means of improving care and reducing costs for critically ill children in rural areas.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1097/PCC.0000000000001330 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
A conceptual framework for identifying and managing system vulnerabilities for diversion of controlled substances in healthcare.
Res Social Adm Pharm
January 2025
Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College Street, Suite 425, Toronto, Ontario, M5T 3M6, Canada; Research & Innovation, North York General Hospital, 4001 Leslie Street, Toronto, Ontario, M2K 1E1, Canada.
Purpose: Diversion or theft of controlled substances is a recognized problem affecting healthcare systems globally. The purpose of this study was to develop a framework for identifying and characterizing system factors leading to vulnerabilities for diversion within hospitals.
Methods: We applied a qualitative framework method, which involved 1) compiling a list of critical diversion vulnerabilities through observations and proactive risk analyses in the inpatient pharmacy, emergency department and intensive care unit of two Canadian hospitals; 2) coding the vulnerabilities into deductively and inductively derived themes and subthemes; and 3) building a conceptual framework.
Protein prenylation in mechanotransduction: implications for disease and therapy.
Trends Pharmacol Sci
January 2025
Department of Cardiology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China. Electronic address:
The process by which cells translate external mechanical cues into intracellular biochemical signals involves intricate mechanisms that remain unclear. In recent years, research into post-translational modifications (PTMs) has offered valuable insights into this field, spotlighting protein prenylation as a crucial mechanism in cellular mechanotransduction and various human diseases. Protein prenylation, which involves the covalent attachment of isoprenoid groups to specific substrate proteins, profoundly affects the functions of key mechanotransduction proteins such as Rho, Ras, and lamins.
View Article and Find Full Text PDFEngineered Au@MOFs silk fibroin-based hydrogel phototherapy platform for enhanced wound healing performance.
Int J Biol Macromol
January 2025
School of Materials Science and Engineering, School of Chemistry and Chemical Engineering, MIIT Key Laboratory of Critical Materials Technology for New Energy Conversion and Storage, Harbin Institute of Technology, Harbin 150001, PR China. Electronic address:
Wound bacterial infections not only impede the healing process but can also give rise to a range of serious complications, thereby posing a substantial risk to human health. Developing effective wound dressings incorporating phototherapy functionalities, specifically photothermal therapy (PTT) and photodynamic therapy (PDT), remains a critical area of research in modern wound care. Existing PTT-PDT systems often suffer from challenges such as nanoparticle aggregation and inefficient reactive oxygen species (ROS) generation, which are essential for therapeutic efficacy.
View Article and Find Full Text PDFChapter 12: PREPARATION FOR PARATHYROID SURGERY.
Ann Endocrinol (Paris)
January 2025
Université Paris-Saclay, Inserm, Physiologie et Physiopathologie Endocriniennes, AP-HP, Hôpital Bicêtre, Service d'Endocrinologie et des Maladies de la Reproduction, Centre de Référence des Maladies Rares du Métabolisme du Calcium et du Phosphate, 94 275 Le Kremlin Bicêtre, France. Electronic address:
Preoperative treatment of PHPT aims to 1) manage severe and/or symptomatic hypercalcemia and 2) prevent postoperative hypocalcemia. Severe hypercalcemia, defined as a blood calcium level ≥ 3.5 mmol/L, requires admission to hospital in a conventional or critical care unit, depending on clinical symptoms and comorbidities.
View Article and Find Full Text PDFEndothelial cell (EC)-specific CTGF/CCN2 Expression Increases EC Reprogramming and Atherosclerosis.
Matrix Biol
January 2025
Department of Surgery, Emory University, Atlanta, GA, USA; Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, USA; Research Services, Atlanta VA Medical Center, Decatur, GA, USA. Electronic address:
Arterial endothelial cells (ECs) reside in a complex biomechanical environment. ECs sense and respond to wall shear stress. Low and oscillatory wall shear stress is characteristic of disturbed flow and commonly found at arterial bifurcations and around atherosclerotic plaques.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!