How new technologies help emergency medicine

In 1854, doctor John Snow revolutionized epidemiological studies. His practice was in London’s Soho district at the epicenter of one of the most serious cholera outbreaks England had ever experienced when more than 700 people died. Snow did a very simple thing: he bought maps of the area and marked where each death occurred. This allowed him to pinpoint the places of highest incidence and demonstrate the source of the outbreak: a water pump on Broad Street. 

The doctor used this thicket of information to convince the authorities to take action. By observing and analyzing his notes, he succeeded in halting the epidemic. Today, in the digital age, no one denies that big data and other emerging technologies improve patient care and the healthcare system. 

A lot has happened since Dr. Snow’s idea, and it has come at an incredible pace. Medicine already makes use of algorithms, artificial intelligence, virtual assistants, robots, drones, portable devices, simulators, and virtual reality. This is especially true in medical emergencies, where a quick and accurate diagnosis is crucial. In this branch of healthcare, which deals with urgent medical conditions that occur beyond the walls of a health center ⁠— from traffic accidents to natural disasters ⁠— there is no doubt about the added value that technology brings.

Artificial intelligence (AI) makes it possible to anticipate certain types of emergencies. Assessing data on armed conflict, famine, or natural disasters linked to climate change ahead of time allows algorithms to establish trends and patterns that are essential to address a health or humanitarian emergency more effectively. Three years ago, in India, algorithms were employed to prevent infant mortality. And it was simple. Medical staff in isolated areas recorded a short video of newborns with a smartphone. These images, detected and analyzed by AI, determined what kind of help these babies need.

Much of the hope for new technologies rests on the unmanned aircraft we call drones. What were only trials a short time ago are now beginning to have a real effect. One example is Rwanda, a mountainous country in East Africa where the majority of the population lives in small, isolated rural villages. In 2016, the Rwandan government signed a contract with Californian startup Zipline for drones to transport bags of blood to remote areas. Today, the company has two centers from which it can make up to 500 deliveries a day. 

Saving time saves lives. Just imagine how this could help a new mother with a hemorrhage or a child with anemia caused by malaria. A group of researchers evaluated the project: out of more than 12,000 orders in 32 months, the time difference between a drone and a motor vehicle on wheels varies between 3 minutes and 211 minutes, depending on the distance and terrain, where the drone always performs better. 

In Europe, the Swedish emergency services (EMADE) has also successfully tested the use of drones. Last December, a 71-year-old resident of the municipality of Trollhättan collapsed in the street following a heart attack. While a passing doctor tried to resuscitate him, his partner called EMADE. Within four minutes a drone created by the company Everdron carrying an automated external defibrillator flew in. The Swedish man saved his life. Around 275,000 Europeans suffer cardiac arrest each year.

A world-first project has succeeded in developing a triage algorithm and incorporating it into a drone to triage accident victims from the air. Spanish company eMedicalDron and CuiDsalud, a research group of the University of Jaén, have already performed simulations. “Drones provide us with decisive information to help us make decisions in highly complex situations. Information is intelligence. Our idea is for drones to become a tool that allows you to make a diagnosis, to determine what is wrong with a patient before the medics arrive on the scene,” Chema López Hens and Sixto Cámara, a doctor and nurse specializing in emergencies and the heads of eMedicalDron, explain to MAPFRE. 

This first aerial and remote triage system using drones can access certain places more quickly and easily, provide data to free up access routes to the site, triage each victim with colors according to severity, check for life-threatening injuries, and more. “The drone may be able to remotely measure vital signs and clinical parameters such as heart rate, respiratory rate, oxygen saturation, etc. — data that is imperceptible to the human eye and will help us make better decisions in less time,” says Chema López.

Miguel Ángel Rodríguez Florido, doctor in Telecommunications Technology and affiliated with the University of Las Palmas de Gran Canaria through the Chair in Medical Technologies of the same University, says that the main barrier to the implementation of technological solutions “is not so much technological capacity as it is the cultural capacity. Many doctors, when they are not used to working with these technologies, lose their sense of control. We have seen this occur with virtual reality, which is essential for recreating emergency environments and situations.”

Rodríguez Florido teaches healthcare workers to operate healthcare technologies. “I compare it to driving a car: once they know how to drive and are familiar with the characteristics and restrictions of the car, how fast they can go and on what kind of track, then the technological tools take on value,” he says.

“Technology is never a substitute for the professional, but solving problems in the virtual environment can help in the physical reality,” he explains to MAPFRE. Doctors and nurses can interact with sound and images in recreations of stressful and first aid situations during volcano eruptions or other natural disasters and in accidents or rescues. With big data and AI, you learn, you correct, and you can anticipate.”

One of the most advanced technologies is in vitro training simulations. As we have seen in the news, the mannequins used in these simulations have evolved a lot in recent years. At first, they were inert dummies that could be opened up to add stitches or inject medicine. “Now, for example, there are arms with sensors that make it possible to monitor all parameters, including where the needle enters, how it affects the organism, and how it reacts to a drug,” says Rodríguez Florido.

If there are any indispensable tools in emergency work, it is portable diagnostic devices. Most mobile units are now equipped with ultrasound scanners for rapid assessment, blood gas analyzers (blood count analyzers) for blood tests, and state-of-the-art respirators. “The problem is that we still do not have the technology to remain interconnected with the hospital and, thus, see the patient in real time from the health center,” says Ricardo Delgado Sánchez, an emergency room nurse and coordinator of the emergency secretariat of the Spanish Society of Emergency Medicine (SEMES – Sociedad Española de Medicina de Urgencias y Emergencias). 

Delgado is aware that the vast majority of out-of-hospital emergencies are related to the elderly and medical conditions arising on the public thoroughfare (trauma, cardiac arrest, minor accidents, etc.). According to SEMES data, “in Spain only 8-10% of calls to emergency services are real emergencies that cannot be delayed. Technology that harnesses big data ⁠— health systems continuously collect and generate data —, telemedicine, information monitoring, and care bots could all help priorities care demands. 

Another of the most effective devices is the so-called PoCUS (Point of Care Ultrasound), a small wireless ultrasound scanner that uses ultrasound to diagnose medical conditions at a location beyond the walls of a hospital or in an ambulance. Through high-definition imaging that does not use radiation, the clinician can make accurate decisions in critically ill patients.

Apps for diagnosis and assistance during travel 

Apps designed for healthcare staff are already available with all the basic information on how to deal with the twenty or so most common medical emergencies on commercial flights, and others for cabin crew to connect with doctors to guide them during delicate moments during flight. 

MAPFRE is one of the large insurance companies that has harnessed new technology to adapt to the types of health emergencies that can arise when traveling or in any day-to-day situation. Savia, its digital health services platform, offers a 24-hour medical consultation and/or chat service every day of the week.  

Furthermore, it has launched MiA (MAPFRE Intelligent Assistance), the 100% digital, multi-channel, customer-focused support solution: a PWA (Progressive Web App) that does not require downloading and allows users to manage emergency travel situations quickly and easily, including video consultation services, medical chat, as well as consultation of the available medical network, among others. 

“MAPFRE Asistencia has evolved thanks to our constant commitment to innovation. Today we are capable of being even closer to our partners and their clients thanks the latest technology. We provide unique, easily accessible solutions that generate the best customer experience,” says Irene García, Deputy General Manager for Business Development and Marketing at MAPFRE Asistencia. 

MiA travel starts with a simple QR code read on the traveler’s cell phone that provides a reliable way to request a video consultation to receive a diagnosis, obtain a refund for pharmaceutical expenses, or find the location of pharmacies and health centers. 

“Telemedicine requires specialized partners who are looking for the right fit among health, wellness and travel, as well as solid, disruptive companies that provide technological solutions for patients and benefits to a broad group. We are constantly identifying potential strategic allies that will allow us to continue to grow the services we offer and enrich our value proposition with a customer focus,” says Deputy Manager of Business Development and Innovation at MAPFRE Asistencia, Javier Gómez.

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