World's First Transcontinental Anesthesia 83
An anonymous reader writes "Medical Daily reports: 'Video conferences may be known for putting people to sleep, but never like this. Dr. Thomas Hemmerling and his team of McGill's Department of Anesthesia achieved a world first on August 30, 2010, when they treated patients undergoing thyroid gland surgery in Italy remotely from Montreal. The approach is part of new technological advancements, known as 'Teleanesthesia', and it involves a team of engineers, researchers and anesthesiologists who will ultimately apply the drugs intravenously which are then controlled remotely through an automated system.'"
Let's hope they are not running Windows (Score:3, Interesting)
A whole new meaning to "Blue Screen of Death".
Re:Encrypted and validated data stream? (Score:3, Interesting)
Really sure I don't trust this. It's bad enough with all the mistakes doctors make now. Now add to it the possibility of service interruption (cut cables, DOS attacks). Then add what could happen if the computers involved become infected with malware. If the systems were isolated, then *maybe* they could be trusted, but in this case, they are not. Then factor in whether or not the doctor is licensed to operate in a particular country...
So you get around this by having a competent team standing by to take over. But in that case, there's very little potential benefit.
Re:Big deal (Score:3, Interesting)
In all honesty, I see and hear a lot about sex toys, particularly off-kilter ones (hazard of the side gigs), and teledildonics is progressing pretty rapidly. They actually have working, commercially available models with bilateral controls... 10 years ago the idea was just a bad joke.
The more you know, the more you sometimes wish you didn't.
Re:Encrypted and validated data stream? (Score:3, Interesting)
Oh, and one more things: For many tasks there is still no better tool than a doctor's assessment. One of those tasks is assessing if a patient is properly anesthetized. There has been no success in developing a tool (including EEG) that can give better results than a doctor's opinion.
Re:Encrypted and validated data stream? (Score:3, Interesting)
"A robot can't do it."
Lots of doctors can't either. From Wikipedia: ....
However, tracheal intubation requires a great deal of clinical experience to master[208] and serious complications may result even when properly performed.[209] When performed improperly, the associated complications (e.g., unrecognized esophageal intubation) may be rapidly fatal.[210] Without adequate training and experience, the incidence of such complications is unacceptably high.[158] For example, among paramedics in several United States urban communities, unrecognized esophageal or hypopharyngeal intubation has been reported to be 6%[211][212] to 25%.[210] Among providers at the basic emergency medical technician (EMT-B) level, reported success rates for tracheal intubation are as low as 51%.[213] In one study, nearly half of patients with misplaced tracheal tubes died in the emergency room.....
Not sure we're there yet (Score:2, Interesting)
The problem with "teleanesthesia", as I see it, is that medical knowledge is only a part of what my presence in the OR provides. The ability to physically intervene is something that can't be done by telepresence (not yet, anyway). If the endotracheal tube comes out during surgery, then you're relying on a technician to replace it. If you need a central line (big IV access in the neck or groin), you need a technician or the surgeon to place it. The hundreds of little things like that are what keep an anesthesia care provider with patients in the OR for the entirWell, as a practicing anesthesiologist at a major academic center on the West Coast, I'd call this interesting but not medically practical at the moment. As a technological breakthrough, it's not really all that novel. So they transmitted vital signs around the world along with a video feed? Okay...but how is that any different from a teleconference?
The problem with "teleanesthesia", as I see it, is that medical knowledge is only a part of what my presence in the OR provides. The ability to physically intervene is something that can't be done by telepresence (not yet, anyway). If the endotracheal tube comes out during surgery, then you're relying on a technician to replace it. If you need a central line (big IV access in the neck or groin), you need a technician or the surgeon to place it. The hundreds of little things like that are what keep an anesthesia care provider with patients in the OR for the entire duration of each and every surgery that goes on.
The other issue as I see it is that monitoring the vitals is important, but there are a lot of things that happen in an operating room that you can't monitor as well over a video feed. How much blood is really being lost? Can I visually sweep the floor, the surgical drapes, and the suction canisters easily and get an estimate? A patient can lose a third to half of their blood volume in some cases before you're going to see that reflected in vital signs, by which time you're way behind.
I suppose there is a place for this kind of thing in battlefield medicine and maybe remote third-world locations, but in those cases the anesthesiologist should be considered a consultant to the people on the ground and not "the primary provider", as it were. In order to make this real-world applicable, you'd need a robot on the far end with visual, audio, and tactile feedback, the ability to move around the room, etc - really a surrogate you that you could reliably control as well as your own hands and eyes. Of course, then you've got the issues with dropped connections, security of the feed, etc. What happens when a script-kiddie hacks your anesthesiabot-3000 and goes nuts with the drug delivery system?
Don't get me wrong, like everyone else I'd love to do my job sitting on my couch in my undies via video feed to the "office", but I'm not really sure this much more than a bit of a publicity stunt at this point.e duration of each and every surgery that goes on.
The other issue as I see it is that monitoring the vitals is important, but there are a lot of things that happen in an operating room that you can't monitor as well over a video feed. How much blood is really being lost? Can I visually sweep the floor, the surgical drapes, and the suction canisters easily and get an estimate? A patient can lose a third to half of their blood volume in some cases before you're going to see that reflected in vital signs, by which time you're way behind.
I suppose there is a place for this kind of thing in battlefield medicine and maybe remote third-world locations, but in those cases the anesthesiologist should be con
A similar story (Score:2, Interesting)