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Minerva Chirurgica 2019 June;74(3):189-94

DOI: 10.23736/S0026-4733.18.07963-4


language: English

The Video-Consulting Emergency protocol: a proposition from the World Society of Emergency Surgery members for the initial management of non-traumatic acute abdomen

Belinda DE SIMONE 1 , Luca ANSALONI 2, Massimo SARTELLI 3, Federico COCCOLINI 2, Josephine A. NAPOLI 4, Fausto CATENA 5

1 Regional Hospital of Perpignan, Perpignan, France; 2 Department of Emergency and Trauma Surgery, Bufalini Hospital, Cesena, Italy; 3 Unit of General Surgery, Macerata Hospital, Macerata, Italy; 4 Department of Anatomy, Biochemistry, and Physiology, University of Hawaii at Manoa, Honolulu, HI, USA; 5 Department of Emergency and Trauma Surgery, University Hospital of Parma, Parma, Italy

BACKGROUND: Our aim is to propose the Video-Consulting Emergency (VCE) protocol as a tool to improve the decision-making process between an on-site emergency physician and a remote acute care surgeon using a smartphone, the FaceTime application, and the Acute Abdominal Decision Making (AADM®) model proposed by World Society of Emergency Surgeons members.
METHODS: The VCE protocol involves the emergency physician and the on-call emergency surgeon. Both must be provided with a smartphone for 24-hour VC with FaceTime application. The AADM® model is a simple, systematic, diagnostic methodology developed by WSES to guide and support physicians throughout the management of acute abdominal pain in the emergency department (ED). FaceTime videoconsulting and the AADM® model con simply systematize the clinical reasoning of the emergency physician when evaluating acute non-traumatic abdomen.
RESULTS: The VCE protocol in ED could be fundamental for an effective first surgical screening and it is an interesting clinical tool with the potential to improve clinical evaluation of patients admitted for acute abdomen.
CONCLUSIONS: The videoconsulting application could decrease healthcare costs related to unnecessary exams, admissions, surgeries or transfers.

KEY WORDS: Telemedicine - Primary health care - Abdominal pain - Acute abdomen

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