PDF(Pubmed)
Abstract：
In Japan, there is a shortage of emergency medicine specialists, often leading non-specialists (physicians who treat conditions outside their area of specialty) to handle cases outside their expertise, which can cause challenges and necessitate specialist support. Starting from December 2023, the St. Marianna University Hospital, which has emergency medicine specialists, began offering overnight emergency outpatient support to Kawasaki Municipal Tama Hospital using the Teladoc HEALTH Mini Cart telemedicine device (Teladoc Health, Inc., CA, USA). The case involved a 44-year-old male with a history of peritonsillar abscess and incisional drainage presented with pharyngeal pain. The treating physician at the Kawasaki Municipal Tama Hospital and a neurologist (the supported physician) examined the patient at 9 PM. An enlarged right tonsil was noted, and a peritonsillar abscess was suspected, prompting a contrast-enhanced CT scan. The results confirmed a 1 cm right peritonsillar abscess. Faced with the decision to transfer the patient to a higher medical facility, the supported physician consulted with the support physician through a Teladoc HEALTH Mini Cart. The St. Marianna University Hospital\'s emergency physician (supporting physician) used the Teladoc HEALTH Mini Cart to assess the patient\'s overall condition, blood tests, and CT images and advise on antibiotic treatment. A visit to the ear, nose, and throat expert (ENT) the following day was considered sufficient. The supported physician received feedback that the use of the Teladoc HEALTH Mini Cart reduced the burden of nighttime transfers for otolaryngological conditions, which can take several hours. This finding suggests that remote medical support can affect Japan\'s emergency medical system.
摘要：
在日本,急诊医学专家短缺，经常领导非专业人员(治疗其专业领域之外的疾病的医生)处理他们专业知识之外的病例，这可能会带来挑战，并需要专家支持。从2023年12月开始，圣玛丽安娜大学医院，有急诊医学专家，开始使用TeladocHEALTHMiniCart远程医疗设备（TeladocHealth，Inc.,CA,美国）。该病例涉及一名44岁的男性，有扁桃体周围脓肿和切口引流的病史，并伴有咽痛。川崎市多摩医院的主治医生和神经科医生（支持的医生）在晚上9点对患者进行了检查。注意到右扁桃体增大，怀疑是扁桃体周围脓肿，提示对比增强CT扫描。结果证实右扁桃体周围脓肿1厘米。面对将患者转移到更高的医疗机构的决定，支持医生通过TeladocHEALTHMiniCart咨询支持医生。圣玛丽安娜大学医院的急诊医师（辅助医师）使用TeladocHEALTHMiniCart评估患者的整体状况，验血,和CT图像，并建议抗生素治疗。拜访耳朵，鼻子,和喉部专家（ENT）第二天被认为是足够的。受支持的医生收到反馈，使用TeladocHEALTHMiniCart减轻了耳鼻喉科疾病的夜间转移负担，这可能需要几个小时。这一发现表明，远程医疗支持可能会影响日本的紧急医疗系统。
