ASOURCE Navi

This winter, there are concerns about a syndemic of coronavirus infection and influenza, and the number of hospitalized patients is expected to increase. For this reason, the labor shortage of medical staff may become serious. Under these circumstances, the movement of "remote ICU", which connects intensive care units (ICUs) with a network and supports medical treatment by specialists from remote locations, has begun. It is expected to be useful for treatment.

In the remote ICU, intensive care specialists, etc. from a remote location constantly support the ICU, analyze data such as heart rate, blood pressure, and images provided from the site and give advice, which is a burden on the medical staff at the site. Is to reduce.

Showa University, which has introduced Phillips Japan's "Remote Intensive Care Unit Management Program (eICU)" (Fig. 1), connects the main hospital support center, the main hospital ICU / ER, and the Koto Toyosu Hospital ICU / ER with a network. A total of 50 ICU beds are monitored from the support center of our hospital. The urgency and severity of each patient, changes in the patient's physical condition, etc. are analyzed and displayed in a list on the monitor so that the staff of the support center can immediately grasp the situation. In addition to continuous monitoring of the patient's condition at the support center, specialists give appropriate advice to on-site staff, reducing the burden on the ICU staff and enabling appropriate early treatment.

At our hospital, the number of severely ill patients with the new coronavirus has increased rapidly since around April, and the number of cases using ECMO (extracorporeal membrane oxygenation) has also increased. It is said that remote monitoring and accurate treatment intervention from the support center shorten the contact time between medical staff and patients, which helps prevent nosocomial infections of the new coronavirus.

On the other hand, Kobe City has introduced and is operating the "remote ICU system" developed by T-ICU at about 20 medical institutions in the city that accept hospitalization for patients with new coronavirus infection. By connecting with a doctor specializing in ICU online, it is possible to provide medical support from a remote location so that advice on new corona support can be received and there is no major bias in accepting patients with new coronavirus infection at medical institutions. The aim is (Fig. 2).

The ICU specialist doctor has a person who is familiar with the new corona medical treatment, and you can consult the treatment policy and the handling of ECMO. In addition, through remote advice, we would like to have private hospitals in the city handle mild to moderate illnesses, and we would like to build a system to focus only on severely ill patients at the Kobe City Medical Center Central Hospital, which is an advanced medical institution. .

This winter, both the new coronavirus infection and influenza are likely to be prevalent, and many people are said to have a sense of crisis about the medical system. It is desirable to find a way to avoid the exhaustion of medical staff.