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Introduction: Radiomedico has been in existence for nearly a century – since 1921, when Captain Robert Huntington established the first service in New York. As embarked Israeli Navy ships do not always have a physician on board, a Medico service has been available for the past several decades.
Objective: An analysis and presentation of the findings, conclusions and recommendations of telemedical services in the Israeli Navy accumulated over a decade.
Methods: All Medico calls in the navy are debriefed after return to shore. We reviewed all debriefings from the years 2006-2016. Computerized patient records were consulted if the sailor's identity was known.
Results: We analyzed 216 cases. Of these, 111 were evacuated to shore, 68 were subsequently transferred to the emergency room. 7 were hospitalized, 1 was dead on arrival. The most common reason for using telemedical assistance was abdominal pain and vomiting (60 cases). The second most common was trauma (24 cases). Of the cases that were considered emergent – 83.3% were evacuated, and 20% were hospitalized. Of the patients who received physician order treatments, fewer were evacuated to shore compared to sailors who did not receive treatment (40% evacuated vs. 77.9%). We also found that patients who received oral anti pain medicine, antiemetic medication or oral antibiotics were less likely to be evacuated {Anti pain medicine: 28% evacuated. Statistically significant (P value = 0.00001), antiemetic medication: 22.2% evacuated. Statistically significant (P value = 0.009), Oral antibiotics: 23.1% evacuated. Statistically significant (Fisher test = 0.043). Patients who were given oxygen were evacuated in 100% of the cases. Another predictor for evacuation was abnormal measurements of body temperature, pulse or blood pressure (60.3% evacuated). Four cases of minor trauma were evacuated to shore but did not need to be taken to the emergency room. We suggest that had a picture been sent to the physician these evacuations would have prevented .
Discussion: Radio consultations in the Israeli Navy in medical cases that were beyond the scope of the ship caregiver's training prevented the need to evacuate approximately half of ill sailors. The merits of naval telemedicine are on the rise, as it is based on advanced technologies and the need remains relevant. The findings of this study regarding telemedicine’s potential to reduce evacuations may signify an age of conceptual transformation in this regard, as technological advancements afford new horizons for telemedicine in general, and maritime telemedicine in particular.
Keywords: Telemedicine; Naval medicine; Radiomedico.