Pediatric tele-resuscitation program saves lives over the phone

When a child turns up at a rural hospital unable to breathe, expert help is one call away.

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McMaster Children’s Hospital’s pediatric tele-resuscitation program connects emergency departments at small, rural hospitals with doctors and nurses who specialize in helping children suffering from a seizure, trauma, sepsis or other respiratory ailment.

Hospital staff aim an iPad mounted on a telescoping head at the patient so the experts at McMaster can advise on how best to stabilize the child and decide on next steps.

“We’re able to help them manage as if we’re standing right there in the room with them,” said Valerie Jansen, clinical leader of the MCH emergency department, in a media release.

“The goal of the program is to improve timely access to expert care so patients can be cared for at their home hospital, especially when they are too sick to go by ambulance or air ambulance to get to us.”

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The aim is to have virtual eyes on the patient within five minutes of the video call coming in. On the line at MCH are at least one emergency room doctor, a charge nurse or trauma nurse, and often a pharmacist to advise on appropriate dosage for children.

The tele-resuscitation program has helped more than 100 young patients in crisis since launching in 2018 at five Niagara hospitals, Hamilton Health Sciences spokesperson Wendy Stewart told The Spectator.

One of the first calls was for a two-month-old unable to breathe due to seizures.

The MCH team suggested changes to the equipment in use — such as getting a breathing tube of a different size — and how to reposition the patient before intervening.

“With these adjustments, they were able to successfully intubate on the first attempt, stabilize the baby, and transfer them to MCH for further care,” Jansen said.

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The pediatric tele-resuscitation program is currently expanding to more than 40 community hospitals in western Ontario, with hospitals in Norfolk County, West Lincoln, Milton, Oakville, Georgetown and Cambridge among those to sign on since March.

The expansion — part of a $48-million provincial funding boost for specialized care at MCH announced in January — saw the hospital hire a project manager and service resource nurse to oversee staff training at each partner hospital.

The province also covers the cost of one iPad — which is operated hands-free — protective case and stand per hospital.

Having experts a video call away is a “godsend” for rural hospitals, said Dr. William Liang, emergency department chief at West Haldimand General Hospital in Hagersville, one of the latest hospitals to be received tele-resuscitation training.

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“Pediatric resuscitation is one of the scariest things a small-town emergency hospital can be faced with,” Liang said.

“For the family, it’s quite reassuring to have something like this, and makes them feel more at ease knowing the doctors are doing their best with guidance from an expert.”

Situations where children need resuscitation are rare at small hospitals like West Haldimand General, but all it takes is one severe infection, allergic reaction, burn or car crash to have an urgent case roll through the door.

“When a child needs resuscitation, it’s all hands on deck,” said AnneMarie VanSickle, clinical director of West Haldimand General’s emergency department.

If the patient has to be transferred to McMaster once stabilized, they get there with MCH staff already up to speed thanks to the virtual consult, giving families peace of mind, VanSickle said.

JP Antonacci is a Local Journalism Initiative Reporter based at the Hamilton Spectator. The initiative is funded by the Government of Canada.

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