Is there a role for telemedicine in disaster medicine?

Early on 27 January 2013, 242 people were killed in a nightclub fire in southern Brazil (Santa Maria) after a band’s pyrotechnic show set the establishment ablaze. The survivors were confined inside the nightclub for an unknown period of time. A few hours later, Hospital Israelita Albert Einstein, a level-one hospital in São Paulo (Brazil), located 1,247 km (775 miles) from Santa Maria, managed to organize a humanitarian aid and disaster relief mission. A regional telemedicine (TM) hub was installed in the Hospital Universitario de Santa Maria, which is one of the main sites that received injured victims. The miniaturized mobile TM platform TES (Transportable Examination Station; GlobalMed Inc., Scottsdale, AZ, USA) was chosen as a practical and lightweight device (Figures 1 and 2). This device operated uninterrupted for 2 weeks after the disaster with at least two videoconferences a day (Figure 3). Unfortunately, 242 people died at the scene. Approximately 620 people needed immediate medical attention and were distributed among nearby hospitals. Approximately 80 victims required admission because of respiratory failure, burn injuries, carbon monoxide and cyanide poisoning, and minor trauma. Mechanical ventilation was performed on 42 patients.