First Video Laryngoscopic Intubation Performed via Telemedicine

From JEMS:

BOTHELL, Wash. – The Department of Emergency Medicine at The University of Arizona College of Medicine Tucson, led by Dr. John C. Sakles, recently performed the first telemedicine-assisted video laryngoscopic intubation using the GlideScope® Video Laryngoscope to assist Northern Cochise Community Hospital, a small, rural healthcare facility in Southern Arizona.

An elderly patient, with a severe COPD exacerbation, presented to the ED at Northern Cochise Community Hospital in Willcox, Arizona. She was aggressively treated with conventional medical therapies and noninvasive ventilatory support, but failed to respond.

The decision was made by the treating physician, Dr. Jacob Poulsen in Willcox, to perform an emergent intubation using the GlideScope® Video Laryngoscope. Dr. Poulsen contacted the Tucson Telebation group at the University of Arizona for assistance. Receiving the call at 10:30 pm, Dr. Sakles, assisted by George Hadeed, MPH, arrived at the University Medical Center (UMC) telemedicine office to supervise the remotely-performed video laryngoscopic intubation.

Over the telemedicine network, Dr. Sakles was able to watch Dr. Poulsen in Willcox prepare the patient for intubation. After the rapid sequence intubation drugs were administered to the patient, and observed via the telemedicine camera view in Tucson, the monitor view was transferred to the view coming from the GlideScope® Cobalt Video Laryngoscope in use by the team in Willcox. The Tucson Telebation Team observed the airway view coming from the GlideScope® Cobalt in the hands of Dr. Poulsen, and provided real-time intubation guidance as the procedure took place.

The intubation went extremely smoothly with no complications, and once the patient was stabilized, she was flown by helicopter to a Tucson hospital for further intensive care management. “We were delighted that the system performed as we expected,” stated Dr. John Sakles, Professor, Department of Emergency Medicine, University of Arizona – Tucson. “The view coming in remotely from the GlideScope® video laryngoscope enabled us to clearly see the airway and provide feedback to the Willcox team during tube placement. We believe this case demonstrates the potential utility that Telebation has in assisting remote hospitals with difficult airways. This is a very promising technology and definitely warrants further study and development.”

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