Accident and Emergency (A&E) medical care is usually delivered by paramedics at the scene of an incident, such as a road traffic accident. A telemedicine system has been investigated which enables other expert clinicians to be telepresent at the accident to support the work of the paramedic, or to plan subsequent medical care.

One of the main requirements for paramedics is a system which is transportable and allowing free movement around the accident site. CamNet, a previously designed system for engineering applications, was tested as a mobile telemedical solution at Ipswich Hospital.

CamNet is an audio-visual headset system which had been developed by BT to allow the user to interact with a distant expert using both audio, video and graphical information, in order to transport the expert's skills to the user in the field. In addition to carrying a conventional microphone and earphone, the CamNet headset has a small CCD camera and a miniature view screen. The screen is viewed with the right eye at a distance of a few centimetres. The optics inside the view screen creates a display which appears equivalent to that of a standard PC monitor viewed at a distance of 1m from the eye.

Wearing the Camnet headset and belt pack - which communicates to the A&E department via a digital radio local area network - the paramedic is able to transmit live pictures back to the clinicans.

• Remote workers, engineers, and medics can access experts whilst in the field

• Added confidence is ensured through shared decision making

• Design changes can be implemented and the results evaluated in real-time

• Problem assessments can be reported from the scene with the addition of real-time video coverage