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  • Yes you have a small hospital at your doorstep and your hospital or general practitioner/family physician (GP) can use the equipment as desired. Ultrasound alone allows you to scan for foreign bodies if you step on a needle, helps in abdominal pain assessment, abscess, minor fractures, joint pain, blood clots, screen for hypertrophic cardiomyopathy and atherosclerotic evaluation. Telemedicine with non-emergency specialists could mean antenatal care at home, diabetic eye screening anywhere.

  • Continuity of care. I.e. ulcers can be monitored by the same doctors globally.
  • Out of hospital IV therapy, and procedures such as thoracentesis or abdominal paracentesis can be performed anywhere with less infection risk.
  • Risks of nosocomial infections decrease.
  • Hospital errors reduced.
  • Immobilization and venous embolism risks diminished.
  • Multiple opinions in emergencies improve outcome.
  • A reduction in vehicle speed thus safer transport may be possible when the diagnosis is known and the hospital is still making the necessary preparations for treatment.
  • Minimizing drugs by earlier therapy reduces side effects.
  • Earlier use of some drugs improves safety, i.e. tPA in ischemic stroke has reduced cerebral hemorrhage.
  • Rare emergencies such as acute angle-closure glaucoma or Addisonian crisis can be pre-planned as directed by your GP.
  • Some emergencies may be treated out of hospital. i.e. septic arthritis and chest pain.

  • This depends in the type of CT scanner chosen. Generally ECU have the mobility of a 10 tonne ambulance; but military units with high wheel base are more adaptable. Medicor has reduced the weight of its latest Stemo Units (Stroke – Einsatzmobile) from 12 tonnes as in the Berlin model, to 5 tonnes in the latest Marburg design.

  • Only drugs that need immediate use to save your life or prevent pain. Others as advised by GPs or specialists, such as prothrombin complex concentrate if on warfarin. Pre-planned patient controlled analgesia. Antibiotic stewardship by telemedicine. Standardized drug concentrations. Any medication may be offered for out of hospital non emergency ECU use, such as chemotherapy with specialist telemedical cover.

  • Generally this is arranged through hospital board of directors or GP (private ECU).

  • Generally a pre-hospital/emergency care physician, with specialists as warranted. GP involvement in private ECUs. Surgical safety check lists are important. Stock control and checking by your paramedic.

  • Yes, for example India restricts the use of ultrasound machines due to feticide and satellite phones, other countries restrict defibrillator use. Complex drug laws exist. Methoxyflurane is licensed in Australia; but not in UK.

  • A full list is found in equipment. Additions as advised by pre-hospital care physicians, specialists or GP  if used privately.  Specialist considerations such as extra corporal membrane oxygenation may need additional planning.

  • This is complicated due to the large range of equipment from 5 CT producers and military vehicle suppliers. Top of the range models would include a 5 member cryo-preservation team. ECU advisers are happy to discuss.

  • Social – Our annual abdominal aortic aneurysm beach party, with teledermatology and toxicology for the jellyfish.
  • Preventative medicine – We offer the only continuous cardiac, renal and gastrointestinal monitoring available as an additional package, using Toto’s intelligent toilet and electric potential sensors. Other prophylactic services would be ECG, echocardiogram, virtual colonoscopy, aneurysm, hepatic, and ovarian scanning, intima-media thickness, teledermatology. Plus the world’s only nocturnal stroke detection and more controversial investigations like CT coronary angiography, pancreatic scans or ankle brachial pressure index. All coordinated through your your institution or GP, if a private ECU.
  • Medical diagnostics – Your hospital or GP has instant access to specialists globally via telemedicine. Outsourcing of medical work is possible.
  • Hospital, surgeon and anesthetic assessments for elective surgery. Physician monitoring.
  • Political – President Gerald Ford’s stroke at the Republican Conference and Kim Jong-il’s situation are examples are examples where executive care can be offered.
  • Financial – Taxation and pyramid selling make ECU free for first customers. Rental possibilities exist. More commercial details are listed in commercial benefits.
  • Altruistic – Your neighbor returning home from carotid surgery will be grateful, as will be the window cleaner’s daughter, after your ECU saved her from choking.
  • Commercial – 52 African dictators would like an ECU.

  • Only in multi-casualty trauma.

  • Yes. Emergencies such as fatal amniotic fluid embolism, subarachnoid hemorrhage Fisher Grade 6. However if it is your second sub-endocardial inferior myocardial infarction we recommend an ECU.

  • Yes. However all companies involved in the transmission of medical data are aware of this issue. Personal medical details will be displayed only to medical personal as directed by your hospital or GP.

  • Yes; but physical limitations need to be discussed with doctors and engineers.

  • Yes, individualized training means your paramedic could also perform other duties such as suturing, vaccinations with appropriate medical cover.

  • This would be individualized with your doctors.

  • Hospital handover as required. Your GP or other specialists will be contacted as desired and details immediately transmitted.

  • Family members will be contacted as requested or as pre-planned.

  • Ambulances have been used as bombs to attack individuals. Regional matters such as the 2011 London riots affected 29 of London’s 33 boroughs, closing roads and 2 hospitals. Not the best day to have a stroke. ECU circumvent this.

  • Hospital selection can be critical. For example survival in head injury is 11% in district hospitals and 37% in neurosurgical units. Traumatic limb amputation is reduced in orthoplastic units.

  • Country medical briefing is important e.g. a business trip to Thailand with a weekend in the Roneam Doun Sam Wildlife Sanctuary might expose your 6 year old daughter to chloroquine, artesunate and mefloquine resistant malaria. As are hazardous activities such as diving. Evacuation plans when helicopter retrieval will improve outcome. Standard operating procedures may vary regionally.

  • Training will be with regional experts i.e. Royal College of Surgeons in Edinburgh Faculty of Pre-Hospital Care in UK. Debriefing locally with your GP if requested. Continuing medical education will involve journal clubs, research, peer experience, with regular practical manikin simulators. Crew resource management as used in the airline industry and open mistake reporting  Specialised training will be required depending on the customers genetic and environmental medical concerns. Education, practice, experience, re-validation and enthusiasm.

  • Industrial, veterinary and dental is possible. There is no reason why your pets cannot be covered. Cricothyroidotomy training is done on dogs. Telemedicine will allow veterinary consultation. Industrial CT use will allow internal inspection of a jammed drill.

  • ECU can either be discrete family units or high profile vehicles.

  • ECU can be staffed it as commercially beneficial. However the best out come would be
  1. An advanced paramedic (who can also drive).
  2. A driver with some paramedical skills.
  3. An ultrasonographer/radiographer who could also assist in intravenous lines and other minor paramedical issues. They need to work as a team as time is critical.
  4. Additionally a 4th person could be present as assistant or training capacity.This could be altered as necessary e.g. if you were doing an inter hospital transfer of a neonate on extra corporal membrane oxygenation, medical specialists would be required.

  • A cheaper staffing concept is using unskilled labor trained only in time saving emergencies and ECU equipment. For example advice on giving thrombolytics in acute stroke can be provided by telemedicine to any member of your family or staff, allowing global cover with minimal costs. Every ECU has a emergency button contacting you immediately, by telemedicine, with your emergency physicians, who can advice and illustrate drugs or procedures using the video wall facilities. Very few emergencies require active intervention prior to telemedical advice, allowing emergency treatment by untrained personel. The only skills which are paramount to all family members are.
  1. Hemorrhage control.
  2. Choking (emergency airway control and cricothyroidectomy).
  3. Cannulation, peripheral venous and femoral access.
  4. Cardiopulmonary resuscitation and defibrillation.
  5. Training in use of ECU equipment e.g CARDIOHELP, ultrasound or RhinoChill is also warranted to supply better treatment; but with high quality telemedicine anyone can be shown by experts how to use most ECU facilities.

  • Yes for two reasons. Firstly they are trained to save you from your collapsed lung and torn liver; but if the noise of an exploding helicopter deafens the entire team optimum care cannot be guaranteed. Secondly all humans make mistakes and your hospital or GP would be informed of all errors that have occurred. Safely issues can affect management, e.g. defibrillation in your swimming pool.

  • As requested with alternative medical services.

  • Medical educational benefits to  staff are considerable, from live discussion of emergency cases, with follow up information  or the collection of date for research.