National study to characterize teletrauma use in United States emergency departments

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BackgroundEmergency department (ED)-based teletrauma service may improve access to trauma expertise, especially in rural areas. However, its impact on patient outcomes remains unclear due to limited understanding of how and what type of care is delivered. The objective of this study was to characterize how EDs in the United States (US) use teletrauma services in clinical practice.MethodsNon-federal/non-specialty EDs, that previously reported using teletrauma, were surveyed in the 2023 National Emergency Department Inventory Teletrauma Survey. The survey was developed and mailed/emailed to ED directors up to two times; nonresponders were contacted via telephone. Survey assessed structural and process measures including staffing, workflows, clinical care, and resource availability. Descriptive statistics were used.ResultsAmong 378 EDs that reported using teletrauma in 2022, 310 responded (82%). Only 68% (211/310) reported using teletrauma in 2023. Most teletrauma-using EDs (TT-EDs) used the service once a month or less (58%), were staffed by non-emergency medicine (EM)-trained providers for in-person care (69%) and EM-trained physicians for remote care (72%). Consults were usually initiated at the discretion of the in-person provider (80%) and often after the patient's arrival to the ED (46%). Clinical applications included decision-support for interfacility transfers (78%), resuscitation-support (71%), documentation (69%) and remote procedural-support (64%) for patients of all ages. Some TT-EDs received trauma education from teletrauma-providing sites (30%), but few reported receiving resources, such as blood products (4%).ConclusionTeletrauma is not widely used in US EDs. Even when capabilities exist, teletrauma use remains limited and insufficiently adapted to rural trauma care.

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