Victims of trauma in rural regions like Vermont and northeastern New York State die at higher rates than their urban counterparts because of difficult access to care at specialized trauma centers.  We have begun to address this problem with an interactive video telemedicine system that allows rural emergency room providers caring for trauma victims to consult with remote trauma surgeons immediately any time of the day.  However, the Emergency Medical Service (EMS) personnel caring for the patient do not have physician support, either at the scene or during transfer to the regional trauma center.




Fletcher Allen Health Care, the University Of Vermont College Of Medicine, and Texas A & M have developed and field tested technology that allows video transmission from the moving ambulance to the emergency room and trauma surgeon by exploiting recent improvements in mobile video conferencing and telecommunications.  FAST STAR, Fletcher Allen Specialized Telemedicine for Supporting Transport And Rescue, is a telemedicine-equipped ambulance that utilizes 3-G cellular technology for two-way audio and one-way video connections while moving.  A pilot study was conducted to test the feasibility of this system for supporting EMT personnel providing care for mock/simulated trauma and obstetrical patients.  Physicians used the base station to observe and communicate with EMT personnel en route to the trauma center.  Physicians completed case evaluation forms on each patient.  In addition, physicians and EMTs completed usability questionnaires to determine if the FAST STAR system was user friendly.

Physicians correctly identified the mechanism of injury and vital signs.  Exams showed variability in the ability to see various injuries through videoconferencing.  However, the results of the study suggest that 82% of the participants agreed or strongly agreed that FAST STAR improved the quality of care for the patient.  In addition, 88% rated the ability to communicate with the EMT as good or very good.  EMT personnel suggested changes that would provide a more hands-free system. The most promising result was the indication that physicians agreed that FAST STAR would allow them to tele-mentor crews who had received training in advanced life-saving procedures.

This technology could be applied in all ambulances and appropriate military vehicles across the country.  The commercial opportunities for this technology include rescue vehicles of all types, as well as ships, aircraft, and other civilian and military applications. 

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