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Cited by 176Telemedicine and Telehealth ImplementationBurn Injury Management and OutcomesTrauma and Emergency Care Studies

Telemedicine Evaluation of Acute Burns Is Accurate and Cost-Effective

Saffle, Jeffrey R., Edelman, Linda, Theurer, Louanna, Morris, Stephen E., Cochran, Amalia·2009·Journal of Trauma: Injury, Infection & Critical Care
DOI 10.1097/ta.0b013e3181ae9b02
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Abstract

BACKGROUND: As the number of US burn centers has declined, access to burn care is increasingly limited. Inexperience in burn wound assessment by referring physicians often results in overtriage or undertriage. In an effort to improve access to burn care in our region, we instituted a program of telemedicine evaluation of acute burns. METHODS: We created a telemedicine network linking our burn center to three hospitals located 298 to 350 air miles away. Participants agreed to perform telemedicine consultation for acutely burned patients admitted to their emergency departments. We compared consults and referrals from these facilities during the period July 2005 to August 2007 (TELE) to those during a 2-year period before instituting telemedicine (PRE-TELE). RESULTS: During the TELE period, 80 patients were referred, of whom 70 were seen acutely by telemedicine, compared with 28 PRE-TELE referrals. The groups did not differ in age or burn size. Only 31 patients seen by telemedicine received emergency air transport (44.3%), compared with 100% of PRE-TELE patients (p < 0.05). Nine other TELE patients were transported by family; 30 other patients were treated locally. Ten remaining patients were transported without telemedicine evaluation. TELE patients transported by air had somewhat larger burn sizes (9.0% vs. 6.5% total body surface area; p = NS) and longer length of stay (13.0 days vs. 8.0 days; p = NS) than PRE-TELE patients. Burn size estimates by burn center physicians made either by telemedicine or direct inspection correlated closely but both differed significantly from those of referring physicians. Providers and patients expressed a high level of satisfaction with the telemedicine experience. CONCLUSIONS: Acute evaluation of burn patients can be performed accurately by telemedicine. This can reduce undertriage or overtriage for air transport, improve resource utilization, and both enhance and extend burn center expertise to many rural communities at low cost.

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Authors
Saffle, J. R., Edelman, L., Theurer, L., Morris, S. E., & Cochran, A.
Affiliations
University of Utah (US)
ORCID
Venue
Journal of Trauma: Injury, Infection & Critical Care
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2009-08
Volume
67
Issue
2
Pages
358-365
ISSN
0022-5282 (ISSN-L)
DOI
10.1097/ta.0b013e3181ae9b02
OpenAlex
W1971700724
Cited by
176
References
61
Citations by year
2026: 2 · 2025: 4 · 2024: 4 · 2023: 12 · 2022: 4 · 2021: 13 · 2020: 24 · 2019: 9 · 2018: 16 · 2017: 13 · 2016: 13 · 2015: 18 · 2014: 10 · 2013: 11 · 2012: 8
FWCI
7.70
Type
journal article
Language
en
Open access
closed
Locations
  • The Journal of Trauma: Injury, Infection, and Critical Care (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
  • Health Sciences › Medicine › Epidemiology › Burn Injury Management and Outcomes
  • Health Sciences › Medicine › Emergency Medicine › Trauma and Emergency Care Studies
Keywords
telemedicine, acute burns, burn triage, airline industry, burn size estimation, emergency department referral, cost-effectiveness, resource utilization (health care)
MeSH terms
Adolescent, Adult, Burns, Child, Child, Preschool, Female, Health Services Accessibility, Humans, Male, Middle Aged, Pilot Projects, Referral and Consultation, Triage, Telemedicine, Young Adult

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