Teleconsultation in the mountains: the role of nurses expert in mountain medicine

Bonin S., Giardini G., Cugnetto M., Pernechele N., Ranfone M., Fiorini A., Collin N., Martinelli M., Pratali L.

Teleconsulto medico 

From June 2017 to March 2018 five trained nurses were involved in the é- Res@mont project to develop a new model of teleconsultation in remote mountain area. Nurses were trained in emergency setting and mountain medicine before starting the activity. The tele-consultation took place in five remote locations between 1.500 and 3.500 m, connected to the doctor through a telematic platform. Communication took place by data transmission, images or via videoconferen-ce. Doctors and nurses choose the validated scales readjusted according to the altitude, defi- ned tools, drugs and identified a protocol to follow in case of connection lacking. On the basis of symptoms patients were submitted to clinical evaluation (i.e. vital parameters, pulse oximetry, BMI, Lake Louise Score questionnaire); moreover an 12 lead ECG and lung echo could be performed. Based on the data received, the doctor made diagnosis and gave instructions to the nurse who provided the care. The activity was carried out for 7 months, with 702 visits (male 61%; averageage 49±17 yrs). The mean value for vital parameters were different according to altitude. The most treated pathologies were AMS 8,0%, Headache 4,0%, minor trauma 2,3%, and gastrointestinal disorders 1,3%. In 30 cases the use of emergency rescue was avoided, specifically in 31% of cases the use of helycopter rescue. The average time of response to the nurse call was 20 minutes. Trained nurses in mountain medicine and telemedicine are crucial: they are link between patients and doctors in the management of critical situation in mountain environment.

Source: XX Convegno Società Italiana di Medicina di Montagna, Bergamo, 13/10/2018