BACKGROUND Trauma is a global burden. Emergency medical services (EMS) provide care for individuals who have serious injuries or suffered a major trauma. OBJECTIVE This paper provides a comprehensive overview of telemedicine applications in prehospital trauma care. METHODS We conducted a systematic review according to PRISMA guidelines. We identified articles by electronic database search (PubMed, EMBASE, the Cochrane Library, CINAHL, SpringerLink, LIVIVO, DARE, IEEE Xplore, Google Scholar and ScienceDirect) using keywords related to prehospital settings, ambulance, telemedicine and trauma. Search terms and inclusion criteria were specified a priori by the PICOS template and revised throughout a configurative approach iteratively, to outline the complexity and variety of different telemedical concepts. RESULTS A final sample of 15 records was systematically selected. Most interventions were piloted and/or evaluated in Germany for trauma victims in prehospital settings. Six studies were simulated scenarios. Telemedical assistance (TMA) via real-time telemetry systems (RTS), enabling video and audio conferencing between EMS by tele-emergency physicians (TEP) were associated with a higher treatment quality and a shorter time-to-treatment in invasive procedures. By initiating in-hospital preparations based on telemedical prehospital notification (TPN), loss of information during the clinical handover was reduced and in-hospital protocols were activated with high accuracy. Remotely guided ultrasound (Tele-Ultrasound) by TEP showed an overall high diagnostic accuracy in simulations. Technical solutions were reliable, seemed practical and auspicious. CONCLUSION The review indicates that TMA and TPN are accompanying telemedical concepts in out-of-hospital trauma care. Well-designed populated studies are needed to fully assess the effect of telemedicine in acute trauma care. Therefore, evidence regarding the effectiveness of telemedicine in prehospital setting for trauma patients is still limited.

中文翻译：

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重伤创伤患者的院前远程医疗紧急管理。

背景技术创伤是全球负担。紧急医疗服务（EMS）为重伤或遭受重伤的个人提供护理。目的本文全面概述了远程医疗在院前创伤护理中的应用。方法我们根据PRISMA指南进行了系统的审查。我们通过电子数据库搜索（PubMed，EMBASE，Cochrane图书馆，CINAHL，SpringerLink，LIVIVO，DARE，IEEE Xplore，Google Scholar和ScienceDirect）使用与院前环境，救护车，远程医疗和创伤有关的关键字来识别文章。PICOS模板事先指定了搜索词和纳入标准，并在整个配置方法中进行了迭代修改，以概述不同远程医疗概念的复杂性和多样性。结果系统选择了15条记录的最终样本。大多数干预措施是在德国针对院前环境中的创伤受害者进行试点和/或评估的。六项研究是模拟情景。通过实时遥测系统（RTS）进行的远程医疗协助（TMA），使远程急诊医师（TEP）在EMS之间进行视频和音频会议，与更高的治疗质量和更短的侵入式治疗时间相关。通过启动基于远程医疗院前通知（TPN）的院内准备，可以减少临床移交过程中的信息丢失，并可以高精度启动院内协议。通过TEP进行的远程引导超声（Tele-Ultrasound）在模拟中显示出总体较高的诊断准确性。技术解决方案是可靠的，似乎是可行的和吉祥的。结论审查表明，TMA和TPN是院外创伤护理中伴随的远程医疗概念。需要精心设计的人口研究来充分评估远程医疗在急性创伤护理中的作用。因此，关于远程医疗在创伤前患者院前环境中有效性的证据仍然有限。