McMaster University

McMaster University

Acute and Remote Care Telemedicine

Telemedicine is the provision of healthcare at a distance using information and communication technologies. It serves a vital component of medical support for remote and isolated communities, and by extension, spaceflight medical support. The Centre is investigating the impact of medical training, communication delay, and the technological requirements for the management of serious medical events in austere environments. To do this, the Centre is developing High-Fidelity Simulation as a natural laboratory for studying these effects and training medical compentency in remote care.

Latest Updates

July 28, 2009

Not much to report since the last update, we've run one simulation since Dr. Musson and Bosco left. This time Bosco teleoperated the high-fidelity simulator from Hamilton, while our local PA telementored myself and one other participant through a straightforward cardiac arrest. The 0.6 second delay proved to be problematic, especially as our training AED did its own thing and wanted to shock our patient with a pulse.

The Mars Institute has posted an impromptu interview with Dr. Musson regarding the project:

— Matt Turnock

July 24, 2009

Well that was close. Dr. Musson and Bosco were unable to leave HMP last night due to heavy fog in Resolute Bay, which would have meant that they would miss their 6:30am flight back to Toronto. A quick phone call to First Air confirmed that there were no available seats until Tuesday, July 28th. Fortunately, a plane from Ellesmere Island was diverted to our small research base because of the same fog, and the pilots agreed to leave at 5am to get Dr. Musson and Bosco to their flight on time. Last report was that they caught their flight and are on their way home!

The next week will see a slow down of the telemedicine research, but we hope to be able to run a few sims, testing out remote control and web-cam only capabilities. Interest from the researchers here and potential teleproviders is still high, so there is no shortage of willing participants.

— Matt Turnock

July 22, 2009

Wow, I can't believe it has been 5 days since the last update! I hope you've been following us on Twitter. There are also 5 new pictures to accompany this update.

We've run a total of 8 simulations so far, with 2 more planned for our final day. Once Dr. David Musson and Bosco Law get back to McMaster University, we hope to run a few more simulations, but with the simulator being controlled from Hamilton, ON instead of up here on Devon Island. Two of our simulations were also run with a simulated lunar time delay of 4 seconds, and our next two will involve Mars-transit communication delays of between 15 and 25 seconds.

We've learned a lot in these past 8 simulations, from an operational point of view, as well as a telemedical point of view. There's no doubt that this research holds serious potential for impacting the healthcare is practiced, educated, and provided in remote and extreme environments. I'm looking forward to the final 13 days of my stay here at the Haughton-Mars Project Research Base.

— Matt Turnock

July 17, 2009

Last night saw our first simulated telementored acute medical emergency, a Twin Otter plane crash on its way to the Haughton-Mars Project. Shortly after dinner, we connected with one of our project team located in New York and presented them with a situation outside of their normal scope of practice.

The challenge was walking two non-medically trained responders through complex tasks to save the life of a rapidly dying simulated patient. Amazingly, within 20 minutes the deadly bleeding from a traumatic amputation had been stopped, an IV line had been inserted, and oxygen was being delivered with assisted ventilations. In that time a rescue plane would only have just finished taking off for the 45 minute flight to the base.

Our first simulation was so rich in information and lessons learned that the research team spent the next three hours analysing the participants' valuable feedback before sleeping at midnight.

— Matt Turnock

July 16, 2009

New photos posted!

Incredible, after a day of hard work our simulated telemedicine system is working perfectly with a few, easily solved glitches. We took the oppourtunity tonight to connect with one of our project medical experts and receive input to fine tune the system.

Tomorrow we expect to jump right into the study by having some initial non-medical participants oriented in, and tele-educated using, High-Fidelity Simulation. We hope to be able to run our first tele-mentored simulated medical emergency shortly thereafter.

— Matt Turnock

July 15, 2009

Things are coming together here with the arrival of Dave Musson and Bosco Law. The rest of the equipment has arrived and we've successfully run an in-house mock "polar bear attack" simulation. I'm pleased to report that everything worked as expected.

So far we've had a lot of interest from the other researchers here and the core staff into our activities. Tonight I will give a quick talk about telemedicine and High-Fidelity Simulation as an introduction to our research protocol, then put out a more formal call for participants. These participants will be directly involved in the medical care of our simulated patient while being telementored by one of our medical experts located around the globe.

— Matt Turnock

July 8, 2009

Three new pictures: Centre for Simulation-Based Learning's photostream

Spent the morning cleaning and organizing the CSA medical tent. Put up the lights, the interior of the tent looks like a spaceship, but is certainly well-lit.

Set up the simulator with it's associated equipment. Discovered that the tongue has torn, probably when i was inflating it, due to the cold reducing its elasticity. Otherwise everything seems to be working normally.

Ran a technical test using a web-cam only based protocol. Vital signs came through clearly, and the video had typical resolution (320x240) and frame rate (15 fps). I'm expecting at least 640x480 at 30 fps for this protocol with our videoconferencing computer, which is still on the way unfortunately.

Next few days will see the C-band satellite dish up and some preliminary operational meetings with the Chief Field Engineer Dr. Stephen Braham from Simon Fraiser University.

— Matt Turnock

July 7, 2009

This will hopefully be the first of many regular updates regarding our field activities at the Haughton-Mars Project Research Base 2009 on Devon Island, Nunavut.

Most of our equipment has finally arrived at Devon Island yesterday, and I've since spent the time organizing simulation supplies, connecting and testing our computer equipment, and generally making myself at home in the CSA medical tent. I'm pleased to report that everything seems to have survived the journey and is working normally in the near freezing temperatures.

Unfortunately the main portion of our audio/video equipment won't arrive until Dr. Dave Musson and Bosco Law arrive on July 14th. Not one to sit around and twiddle my thumbs, tomorrow Bosco and I will test run a webcam-based VoIP videoconferencing solution between HMP and McMaster for integrating High-Fidelity Simulation with telemedicine.

- Matt Turnock

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