Rapid Deployment of International Tele-Intensive Care Unit Services in War-Torn Syria
Rapid Deployment of International Tele-Intensive Care Unit Services in War-Torn Syria
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DOI：
10.1513/annalsats.201509-589ot
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发表时间：
2016-02-01
影响因子：
8.3
通讯作者：
Weinert, Craig
中科院分区：
文献类型：
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作者：
Moughrabieh, Anas;Weinert, Craig
叙利亚冲突造成了21世纪最大的人道主义紧急情况。4年的叙利亚冲突摧毁了医院，严重降低了重症监护室（ICU）和现场重症监护医生的能力。这场危机促使国外试图支持叙利亚境内重伤和重病平民的医疗护理，包括应用远程医疗。在美国，远程ICU项目已经运行了十多年，尽管启动成本很高，开发时间通常很长。从这些国内模式中吸取的经验教训，叙利亚远程ICU计划于2012年12月启动，通过使用廉价的现成摄像机，免费的社交媒体应用程序以及北美和欧洲讲阿拉伯语的重症监护医生志愿者网络来管理叙利亚部分地区的ICU患者的护理。1年内，3个ICU每月有90名患者接受远程ICU服务。2015年底，一个由大约20名重症监护医生组成的网络每天24小时为叙利亚的五个民用ICU提供临床决策支持。志愿临床医生管理距离超过6,000英里的患者，北美和叙利亚之间相隔七八个时区。该计划正在为医生文档和护士的药物管理记录实施基于云的电子病历。还有虚拟聊天室，用于查房、放射学回顾和实习生教学。该计划的早期成功表明，少数忠诚的医生可以使用互联网革命产生的廉价设备，在一个冲突严重的国家支持远程平民医疗服务。
The conflict in Syria has created the largest humanitarian emergency of the twenty-first century. The 4-year Syrian conflict has destroyed hospitals and severely reduced the capacity of intensive care units (ICUs) and on-site intensivists. The crisis has triggered attempts from abroad to support the medical care of severely injured and acutely ill civilians inside Syria, including application of telemedicine. Within the United States, tele-ICU programs have been operating for more than a decade, albeit with high start-up costs and generally long development times. With the benefit of lessons drawn from those domestic models, the Syria Tele-ICU program was launched in December 2012 to manage the care of ICU patients in parts of Syria by using inexpensive, off-the-shelf video cameras, free social media applications, and a volunteer network of Arabic-speaking intensivists in North America and Europe. Within 1 year, 90 patients per month in three ICUs were receiving tele-ICU services. At the end of 2015, a network of approximately 20 participating intensivists was providing clinical decision support 24 hours per day to five civilian ICUs in Syria. The volunteer clinicians manage patients at a distance of more than 6,000 miles, separated by seven or eight time zones between North America and Syria. The program is implementing a cloud-based electronic medical record for physician documentation and a medication administration record for nurses. There are virtual chat rooms for patient rounds, radiology review, and trainee teaching. The early success of the program shows how a small number of committed physicians can use inexpensive equipment spawned by the Internet revolution to support from afar civilian health care delivery in a high-conflict country.