Remotely Supported Prehospital Ultrasound: Real-time Communication for Diagnosis in Remote and Rural Communities

We have created a system that aims to facilitate prehospital assessment of remote and rural patients using remotely supported ultrasound (US) and a novel communications device. Paramedics can function as remotely supported US operators, guided and advised by hospital-based specialists regarding diagnosis and treatment options. Novel communication technology can link these users in areas with low communications coverage by connecting to multiple cellular networks and/or satellites to stream live US and video images, plus two-way audio. A demonstrator system was used in locations around the Scottish Highlands to stream images to remote reviewers for image interpretation, as well as sending audio and video to allow mobile telestroke assessments while in transit. Connections with live US and audio-visual transmission were successful, with appropriate views provided in 94% scans. All telestroke assessments were completed successfully. This prehospital support US system could facilitate early diagnosis and streamlining of treatment pathways for remote and emergency patients. It could be particularly applicable and useful in rural areas worldwide with poor communications infrastructure and extensive transport times.