34: Telemedicine to Reduce Risk in Austere Environments

Telemedicine is a crucial capability that must be planned and practiced.  The base of knowledge that a SOF medic's knowledge encompasses includes many areas of medicine but generally lacks the depth and experience of specialists available to consult.  This depth of knowledge is almost universally available when making a simple telephone call to any number of docs willing to take a call at all times of the day and night.  Don't let pride or hubris prevent you from seeking advice from someone more experienced than you in taking care of critically injured, complex patients.  Telemedical consult is one of the most important core capabilities in a prolonged field care situation. BOTH the medic making the call as well as the Provider receiving the call must practice and rehearse a telemedical consult placed from a field environment.   The medic will gain confidence and be able to relay vital information efficiently in a timely manner.  The provider on the other end will have to anticipate problems that the medic may not have thought of and help create a prioritized treatment care plan from incomplete information. Trust must be built prior to an actual call being made under stressful conditions; trust in the receiving physician and, more importantly, trust in the process.  Medics may be apprehensive in calling a complete stranger if they haven't made a test call or even better, a face to face meeting.  If you build the rapport before the crisis, this won't be an issue.  You may even have the time to prep a draft email who you are and your equipment, training level and usually a region where you will be if you think it will be pertinent.