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Tele-health services support children province-wide

​When a 10-year-old girl arrived febrile, lethargic and coughing up blood at R.W. Large Memorial Hospital in Bella Bella recently, it’s unlikely her parents knew about the recent expansion of tele-health service connections to BC Children’s Hospital.
 
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​R.W. Large Memorial Hospital team (left to right): Sian Carter (coordinator/educator), Dr. Payman Nabai (MD), Gary Housty (manager of Clinical Services), Susan Chatelier (RN) and Emily Godsil (RN).

They just knew their daughter needed immediate medical attention.

Compounding the patient’s acutely ill state was a CPT1 deficiency, which is more prevalent in First Nation’s communities. Patients who are CPT1 deficient do not have the enzyme needed to convert fat to energy, which means they are at high risk to go into hypoglycemic shock and possibly a coma unless they receive rapid sugar replacement therapy. 

Following an assessment, it was deemed the patient needed to be medevaced to BC Children’s; but it was too late in the day. Dr. Nicole Redding, the physician on duty that night, and Sian Carter, Patient Care coordinator/educator at the Central Coast Hospital, immediately mobilized the Bella Bella team to connect with the tele-pediatric intensive care unit (tele-PICU) at BC Children’s.

“Within 90 minutes of arrival, the family, the patient, MD and nursing team were face-to-face consulting with the tele-PICU intensivist and a nurse specialist at BC Children’s,” said Sian. “These professionals were able to guide our care planning and interventions for effective management of this patient. The face-to-face interaction also helped provide reassurance and consolation to a very worried family.”

Celebrating Digital Health Week

Digital Health Week is November 13-19 and this story highlights how digital or tele-health is especially relevant for rural and remote communities, such as Bella Bella (population 1,500). On a daily basis, hospital staff encounter challenging issues including high acuity patients, limited access to resources and a strong reliance on transferring patients to a higher level of care in urgent/emergent situations. Inclement weather or the time of day often makes a transfer impossible, however.

In emergency cases, digital or tele-health is transforming the delivery of care – and saving lives.

“Through Child Health BC, a partnership with the province's health authorities, we’ve had the opportunity to work with multi-disciplinary teams in some of BC’s most rural communities to connect them to very specialized care, and even critical care, closer to home,” said Dr. Maureen O'Donnell, executive director, Child Health BC, BC Children's Hospital. “The continued expansion of tele-health services allows teams to collaborate across the province to help children receive diagnosis and treatment sooner.” 

Tele-PICU a Canadian first

The first program of its kind in Canada, tele-PICU was launched in summer 2016 and allows teams at BC Children’s, to assess children closer to their community through real-time, two-way videoconferencing. Tele-PICU teams use high resolution cameras and digital stethoscopes that enable physicians and nurses to see patients, as well as to listen to and amplify sounds of the heart and lungs of seriously ill or injured children. The teams are supported by carefully planned processes and protocols, leading edge equipment and 24/7 technical support.

Children’s Virtual Care Initiative

Tele-PICU is part of Child Health BC’s Children’s Virtual Care initiative that integrates tele-health and other technologies to enhance services to children throughout BC. These sites include technology and tele-health equipment as well as equipment to support pediatric visits with trained nurses and support staff. 

Children's Virtual Care is available in 17 communities, four of which include tele-PICU. Availability will expand in areas where families experience the greatest challenges of isolation and geographical barriers.
BC Children's Hospital
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