Emergency Services

Emergency Services

Quick access to expertise when you need it most

Telemedicine can be an effective way to bring specialized emergency care and timely treatment to patients in need. In addition to equalizing health care for Ontarians facing urgent or emergent health issues, telemedicine can provide an important communications channel during a pandemic or natural disaster, reduce costs, help to ensure the sustainability of the healthcare system, and reduce the environmental impact of health care.

The Benefits

Why do emergency care providers use OTN?

  • Bring timely treatment to patients in need;
  • Bring scarce specialized critical care resources “to the bedside”;
  • Aid decision making about stabilization and transport;
  • Avoid inappropriate or unnecessary transfers, as well as admissions and readmissions;
  • Enhance the readiness of emergency personnel for the arrival and treatment of patients; and
  • Enable distributed rapid response teams to come together for comprehensive care.

Have more questions? Feel free to contact us here.

Teleburn

The Sunnybrook Teleburn Program is an urgent/emergent telemedicine application which allows for the assessment and treatment of burn patients using live, two-way videoconferencing with a remote burn specialist located at the Ross Tilley Burn Centre.

The specialists at the Ross Tilley Burn Centre can help provide care prior to transport to a burn centre, or provide advice to prevent transport of the patient and guide care at the referring site to reduce patient and family travel.

 

How it works
The Sunnybrook Teleburn Program:

  • provides 24/7 emergency burn service via OTN;
  • uses CritiCall Ontario to contact a burn specialist at the Ross Tilley Burn Centre;
  • supports discussions between physicians and the health care team regarding the treatment of burn patients; and
  • provides access to burn specialists for follow-up, if required.
To access Teleburn:

  1. Contact CritiCall Ontario at 1-800-668-HELP (4357) and ask for a teleburn
  2. Provide your location, site and video system number to the consultant at the time of the initial phone consult.
  3. Complete and fax a Information for Teleburn Consultants form at the conclusion of the consult.

Teleburn resource materials, including billing forms and a video message from Teleburn Program Lead Dr. Marc Jeschke are available in the Emergency Services section of the Knowledge Centre Resource Library.

Essentials
To participate in Teleburn, referring sites must have:

  • telemedicine-enabled clinical area (e.g. emergency department) – with a peripheral handheld camera, if possible (not mandatory);
  • knowledge of the referral protocol and patient eligibility criteria; and
  • ability to clinically present via telemedicine.
Patient criteria for referral to Sunnybrook’s Teleburn Program:

  • teenagers, adults and the elderly
  • burn injuries including:
    • electrical burns
    • chemical burns
    • suspected Stevens-Johnson Syndrome (SJS) / Toxic Epidermal Necrolysis (TEN)
    • frost bite
    • third degree burns

Telemedicine can be an effective way to bring specialized emergency care and timely treatment to patients in need.

Virtual Critical Care

North East (NE) LHIN Virtual Critical Care (VCC), led by Health Sciences North gives virtual access, using telemedicine, to critical care specialists who collaborate with the referring site in managing care of the critically ill patient. This provides:

  • provide 24/7 Intensivist-led interdisciplinary ICU services through two-way videoconferencing regarding care of critically ill adult patients;
  • support initial and follow up consultations, daily multi-disciplinary rounds, and discussions prior to or in place of patient transfer to a facility which can accommodate a higher level of care;
  • support to local care;
  • facilitates the sharing of resources, best practices, educational opportunities; and
  • facilitates partnerships for improvements in patient care.

This may result in the patient avoiding transfer so the patient and family do not need to travel. Alternatively, the team assists with the decision to transport to a facility which can accommodate a higher level of care.

Virtual Critical Care has enabled patient care such as:

  • Addressing level of treatment and palliation plan
  • Ordering medications, lab tests, echo, x-rays, reviewing ECGs
  • Critical Care Pharmacist consulting for weight and renal adjusted dosing, anti-biotic adjustments
  • Starting vasopressor and antiarrhythmic support
  • Initiation of non-invasive ventilation
  • Critical Care dietitian requests for service
  • RT consultation for assessment (review of ABGs)
  • Initiation of antiviral therapy

“So far this week, we have partnered with our remote hospitals to save the life of one patient and prevented two transfers…all with good patient outcomes and happy patients & families. Overall, it’s been a great week!”

Dr. Randy Wax, HSN VCC Intensivist

How it works
Sites in the NE LHIN that have an ICU or emergency department and have been trained for the VCC may participate in the service.

Patient inclusion criteria:

  • Adult patients that are critically ill or medically unstable.
  • Adult patients with compromised airway or breathing, hemodynamically unstable or with a decreased level of consciousness.
  • Adult patients for which there is a serious concern.

Participating organizations can access the VCC by contacting CritiCall (1-800-668-HELP) and asking for a Virtual Critical Care consult.

Essentials
Participation in the VCC Service requires that referring sites meet certain criteria, including:

  • a telemedicine enabled clinical area (e.g. ICU, emergency department);
  • knowledge of the referral protocol and patient eligibility criteria; and
  • the ability to clinically present the patient via telemedicine.

“We are very pleased to be a part of VCC and certainly are learning so much interacting with HSN staff. To have an entire interdisciplinary team at our fingertips to collaborate with is exceptional.”

Patti Todevic, Manager Patient Care Services Elliot Lake

Teletrauma

The Toronto Teletrauma Program (3T), a partnership of St. Michael’s Hospital and Sunnybrook Health Sciences Centre, was developed to connect physicians and improve access to quality trauma care. The Program allows for the assessment and treatment of trauma patients through a “consult” using live, two-way videoconferencing with a remote trauma specialist.

Teletrauma can expedite transfer, help aid in care prior to transport to the trauma centre, or provide advice to prevent transport of the patient and help to guide care at the referring site so the patient/family do not need to travel.

How it works
The Toronto Teletrauma Program:

  • provides 24/7 emergency trauma service via OTN;
  • uses CritiCall Ontario to contact a trauma specialist at St. Michael’s or Sunnybrook and;
  • supports discussions between physicians and the health care team regarding the stabilization and treatment of trauma patients prior to, or in place of, transport to the trauma centre.
Essentials
Referring sites participating in 3T must have:

  • pre-approval for participation from the Toronto Teletrauma Program
  • a telemedicine-enabled clinical area (e.g. emergency department);knowledge of the referral protocol and patient eligibility criteria; and
  • ability to clinically present via telemedicine.

Patient criteria for referral to 3T:

  • adults (16 and over) and the elderly;
  • unstable blunt trauma patients, or any penetrating injuries;
  • consult only, or consult then transfer to a trauma centre.

” … it really facilitated decision making to actually see the patient….They were pretty reluctant to intubate but I was able to convince them that it was the only safe way to get her scanned and then transferred to a higher level of care. It was a much easier decision for me to make after having seen
her, rather than just relying on their descriptions.”

Teletrauma Consultant