In Medicine, What Is Remote Guidance?

Remote guidance allows an experienced care provider to supervise procedures from a distant location. This has potential applications for emergency medical treatment, where every minute can count, as well as management of patients in locations that are hard to access, like the International Space Station or research facilities in Antarctica, which can be inaccessible in the winter. A variety of equipment can facilitate remote guidance, which is a branch of telemedicine, where telecommunications equipment is incorporated into medical treatment.

For this technique to be effective, it needs to be available in real time with minimal risk of network interruptions and disruptions, because they might come at a critical moment. Imaging equipment on the patient’s end can feed to a physician or technician on the other, who can provide instruction for emergency medical technicians, bystanders, and others who may be present. In addition to images, the system can also feed information like vital signs, electrocardiogram readings, and other data to the person offering instruction.

One application of remote guidance is in real time diagnostic imaging. A technician with appropriate equipment can acquire images under instruction from a radiologist who can also read them remotely. This provides access to immediate ultrasound evaluation for injuries in sports settings, as well as in situations where patients might not be able to access a radiologist. Remote guidance can also be used to instruct people as they perform procedures to secure a patient’s airway or stabilize the patient for transport.

Phone-only remote guidance can be an option in emergencies where it is not possible to establish an image, but outcomes tend to be better with clear imaging of the patient and the scene. This can include endoscopic cameras inserted into the patient to show the doctor what is going on inside while the team works. Phone coaching can be suitable for basic activities like administering an epinephrine injection to someone with a known bee allergy.

Studies on telemedicine show that people can achieve good patient outcomes if they receive appropriate supervision. Physicians learning to use remote guidance systems may need some assistance as they learn to navigate the system and develop techniques for instructing people when they cannot step in or show them techniques. The ability to teach clearly and effectively is important, as is the ability to remain calm in emergencies to keep people on the other end relaxed so they can focus on the task at hand.