Browsing by Author "Ferguson, J"
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- ItemAir sea rescue, telemedicine style.(2002-09-09) Ferguson, J; Aujla, K; Pedley, D; Palombo, AHistorically requests from shipping in UK coastal waters for emergency medical advice have been handled on an ad hoc basis by various accident and emergency departments on behalf of the Coastguard A formal contract to provide this service has recently been established with the Aberdeen Royal Infirmary in Scotland and the Royal Alexandra Hospital in Portsmouth England A pre contract audit showed that the involvement of medical professionals in the evacuation decision improved the quality of triage and intervention The medical staff at both hospitals received training in giving medical advice and the level of medical knowledge that could reasonably be expected of ships crews Providing advice to commercial airlines developed from the maritime service In association with a private company staff at the Aberdeen Royal Infirmary have developed procedures to support cabin crew and medical professionals on board initial figures suggest that a medical professional is present on about 45 of flights At present although there are insufficient data to draw any firm conclusions it appears that up to two thirds of diversions could be avoided using this service
- ItemCan paediatric radiographs be accurately interpreted using an inter-hospital telemedicine system?(2002-09-09) Palombo, A; Haigh, T; Ferguson, J; Pedley, DChildren make up a significant proportion of attendances at accident and emergency departments but there is little published information about the use of telemedicine for viewing paediatric radiographs in the emergency setting The radiographs and case notes of 30 children were randomly selected from attendances at an accident and emergency department and were then transmitted over a telemedicine link equipped with a document camera The doctor recorded the diagnosis and proposed management along with the confidence in diagnosis and satisfaction with the image This process was repeated using hardcopy radiographs and a standard viewing box Five accident and emergency specialists took part in the study there were in total 300 radiograph viewings There was one missed fracture out of 75 positive radiographs viewed by telemedicine compared with no missed fractures on direct inspection of the film Thirteen radiographs viewed over the telemedicine link were thought to be positive or suspicious of injury when the formal report was of no bony injury The sensitivity of fracture diagnosis using telemedicine was 98 6 compared with 100 on direct inspection of the film and specificities were 82 6 and 86 6 respectively Our study suggests that telemedicine can be used to aid diagnosis and make management decisions in children with minor trauma
- ItemCommunity coronary units: strategies to promote pre-hospital thrombolysis.(2002-09-09) Pedley, D; Ferguson, J; Palombo, A; Richardson, JEarly diagnosis and the early delivery of pre hospital thrombolysis in cases of acute myocardial infarction AMI have been shown to decrease mortality Despite strong evidence of its benefits pre hospital thrombolysis rates are still worryingly low The challenge is to empower community practitioners to deliver thrombolysis In the Grampian region there is a network of community hospitals which have been equipped with both videoconferencing and remote telemetry equipment This allows realtime consultation with the local accident and emergency department and coronary care unit Early trials of the system show that clinical information can be viewed in realtime with transfer of a 12 lead electrocardiogram at 60 s intervals This will give general practitioners unprecedented access to specialist advice Our aim is to use a combination of teaching and decision support technology to ensure that all patients with AMI have the opportunity to access timely and appropriate prehospital thrombolysis
- ItemEvaluation of a pilot telemedicine network for accident and emergency work.(2002-09-09) Brebner, E M; Brebner, J A; Ruddick-Bracken, H; Wootton, R; Ferguson, JA pilot accident and emergency teleconsulting service was established in Scotland It was based at the accident and emergency department of the main hospital in Aberdeen There were three peripheral sites in rural Grampian Peterhead Turriff and Huntly and one in the Shetland Isles The videoconferencing equipment used was connected by ISDN at 384 kbit s During the 15 months of the study 1998 videoconference calls were made of which 402 20 calls were made to the accident and emergency department for clinical consultations The majority of the clinical calls 95 were made between 09 00 and 17 00 and more than 90 were completed within 20 min During the majority of calls 87 one or more X ray images were transmitted The majority of patients 89 received treatment without transportation to the main centre in Aberdeen The present study demonstrated that accident and emergency teleconsultations can be technically reliable effective in reducing the number of patient transfers and acceptable to the referring clinicians As a result approximately 1 5 million has been made available by the government to develop a national system for Scotland
- ItemAn evaluation of a telemedicine fracture review clinic.(2003-09-03) Palombo, A; Ferguson, J; Rowlands, A; Pedley, D; Fraser, STelemedicine is being widely used in the treatment of patients with minor injuries in north east Scotland A telemedicine fracture review clinic has been developed During a one month study period there were a total of 67 review appointments and 88 new patients Fifty individual patients were reviewed and 10 were seen on more than one occasion The mean number of reviews for all patients was 2 3 Thirty six patients had initially been seen by telemedicine six of whom 17 had to come to Aberdeen for part of their treatment Fourteen patients reviewed by telemedicine had initially been seen in person All patients were safely managed and normal guidelines were followed There is scope for significant expansion of this service since 131 patients were seen in a fracture clinic in Aberdeen who lived close to a minor injury unit with telemedicine and X ray facilities The majority of these patients were likely to have had injuries suitable to be followed up using telemedicine
- ItemEvaluation of an accident and emergency teleconsultation service for north-east Scotland.(2004-03-09) Brebner, E M; Brebner, J A; Ruddick-Bracken, H; Wootton, R; Ferguson, J; Palombo, A; Pedley, D; Rowlands, A; Fraser, SWe evaluated an accident and emergency teleconsultation service provided to 14 community hospitals in north east Scotland Each community hospital was equipped with a videoconferencing system and a document camera to allow transmission of radiographs The network used 384 kbit s ISDN connections A total of 1392 teleconsultations were recorded during a 12 month study period Seventy seven per cent of patients n 1072 were managed locally and 23 n 320 were transferred to Aberdeen The majority 95 of teleconsultations were conducted on weekdays and 90 of these occurred between the hours of 09 00 and 16 00 The mean delay in contacting a doctor was 9 min and the mean consultation time was 10 min The majority of patients were suffering from fractures or suspected fractures of the limbs Radiograph transmission was used in 75 of all teleconsultations A high degree of satisfaction was recorded by all users of the service
- ItemThe importance of setting and evaluating standards of telemedicine training.(2003-09-03) Brebner, E M; Brebner, J A; Ruddick-Bracken, H; Wootton, R; Ferguson, JThe importance of appropriate training in the use of videoconferencing equipment for clinical purposes is often underestimated when telemedicine projects are established We developed a user training programme which was delivered via videoconferencing to a group of 130 nurses Training was delivered on a one to one basis A questionnaire was developed to evaluate user satisfaction and the effectiveness of training One hundred and two fully completed questionnaires were returned a 79 response rate High levels of satisfaction were obtained but the level of user competence reached 100 only when training was supported by a training manual and at least weekly practice Before establishing a telemedicine service the following steps appear to be important identify the required training competencies deliver a hands on training programme based on the required training competencies back up the training programme with an instruction booklet ensure that trainees have at least weekly practice measure the level of user competence
- ItemMinor injuries telemedicine.(2003-09-03) Ferguson, J; Rowlands, A; Palombo, A; Pedley, D; Fraser, S; Simpson, SA minor injuries telemedicine network in Grampian connects 14 accident and emergency departments in community hospitals to a teaching hospital department In a six month study 407 new telemedicine consultations met the inclusion criteria Rates of transfer for treatment to the base hospital were used as an outcome measure Fourteen out of a total of 19 members of medical staff gave telemedical advice They were mainly middle grade accident and emergency doctors Transfer rates were 16 48 median 29 across staff The rates did not seem to be affected by the base doctor s seniority but were a reflection of that doctor s experience of and confidence in using videoconferencing equipment for clinical purposes Transfer rates decreased as experience increased Training for doctors undertaking the provision of specialist advice should include the clinical practicalities of making remote diagnoses
- ItemRationalizing radio medical advice for maritime emergencies.(2003-09-03) Aujla, K; Nag, R; Ferguson, J; Howell, M; Cahill, CThe provision of radio medical advice by the National Health Service for British coastal waters has developed in an ad hoc fashion In 1999 the closure of one of the two centres providing such advice led to unexpected problems The demographic characteristics of the offshore population covered by each centre were markedly different and this resulted in a different spectrum of medical emergencies presenting to the sole remaining centre Subsequent data collection of the details of medical emergencies presenting from offshore allowed an audit to inform the development of training packages for both base and remote practitioners This has led to an ongoing national rationalization of ship to shore radio medical advice for the UK
- ItemTelemedical management of an odontoid peg fracture in the Shetland Isles.(2001-03-26) Docherty, E M; Ferguson, J
- ItemTransfer of telemedical support to Cornwall from a national telemedicine network during a solar eclipse.(2000-05-25) Wootton, R; McKelvey, A; McNicholl, B; Loane, M; Hore, D; Howarth, P; Tachakra, S; Rocke, L; Martin, J; Pagé, G; Ferguson, J; Chambers, D; Hassan, HDuring late 1998 and early 1999 planning officers in Cornwall predicted a huge increase in summer visitors to the county to observe the August solar eclipse There was the possibility that a mass gathering in Cornwall could overload existing arrangements for handling accident and emergency patients We therefore set up a telemedicine system to support the county s minor injury units MIUs from hospitals throughout the UK Six main hospital accident and emergency departments outside Cornwall with existing links to their own MIUs were twinned with 10 of the 11 MIUs in Cornwall before the expected date of the gathering The network was live for nine days starting four days before the eclipse and 2045 patients were seen in the 10 MIUs There were 93 telemedicine calls from the 10 MIUs involving 91 patients Overall 4 6 of the patients required a telemedicine consultation Fifty seven calls were made during working hours Thirty four patients were referred for further management of whom 18 were referred on the same day The transfer of telemedical support to a national network was successful