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World's First Transcontinental Anesthesia
An anonymous reader writes "Medical Daily reports: 'Video conferences may be known for putting people to sleep, but never like this. Dr. Thomas Hemmerling and his team of McGill's Department of Anesthesia achieved a world first on August 30, 2010, when they treated patients undergoing thyroid gland surgery in Italy remotely from Montreal. The approach is part of new technological advancements, known as 'Teleanesthesia', and it involves a team of engineers, researchers and anesthesiologists who will ultimately apply the drugs intravenously which are then controlled remotely through an automated system.'"
This is truly a breakthrough, but not one with which I am particularly thrilled. I am definitely not comfortable with my life being in the hands of a doctor half way around the world with only a small view of what is going on, and one that depends entirely on network availability.
Also, if something goes wrong that is beyond the scope of what the robot is capable of, how am I guaranteed a competent doctor will be right there locally ready to step in and take over?
While this might be a big TECHNOLOGICAL advancement, I can't really see how this is a MEDICAL advancement or a viable cost-saving measure for health care.
My university has loads of remote learning resources that have a similar effect!
Disclaimer: I am a doctor, Jim, not a ****.
A few problems:
1) The technical act of anesthetizing a patient involves, amongst other things, putting a tube inside the patients trachea (AKA intubation) so he can be artificially ventilated - a task that demands a qualified human being. A robot can't do it. Even if you could develop a robot to do it, you would want someone near at hand in cases of difficult intubations.
2) Some operations need more than just a regular IV (intravenous) line and intubation. Sometimes you need a central venous line, arterial line, urine catheter, gastric tube, etc. I don't know how it is in the US, but in Israel most, if not all, of these procedures are performed by the anesthesiologist.
3) In 95% of the cases the anesthesia is going smoothly throughout the operation and the anesthesiologist can sit back and relax (and try not to fall asleep). However, in some of the cases things go wrong. Some of them are easy to fix (blood pressure too low/high - give medication X/Y). But some are harder. For example, in one operation I was in, the patient's O2 saturation went plumbing down. What was the problem? The tubing from the intubation tube to the ventilation machine got disconnected along the way. The anesthesiologist is the one who needs to solve problems such as this. Even for the easy problems, when they happen you want a speedy response. If something happens to the connection at the critical time (and statistics assure you that once in a while something bad will happen at the worst possible moment), the patient could suffer. Gives a whole new meaning to "Denial-of-service" attack.
4) Even if nothing goes wrong, some operations (esp. in the head and neck region) need the anesthesiologist's help during the surgery.
5) The waking up part of the operation also needs an anesthesiologist in the room to carry out some procedures (e.g. extubating the patient, suctioning his airways, making sure he is breathing OK, re-intubating if he can't breath well).
So, while I am all in favor of automation, robots and remote control, I for one see plenty of downsides, but no upside. If anyone has an idea how this can help the patient, I would be glad to start thinking about the cost/benefit ratio. Right now, for me, the ratio is approaching infinite.
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