Use of home telemedicine for critical illness rehabilitation: an Indian success story.
Dileep C UnnikrishnanDileep RamanDhruv JoshiB S AjaikumarPublished in: BMJ case reports (2019)
One-fifth of healthcare beneficiaries in developed nations get discharged from hospitals to physician supervised skilled nursing care facilities. In low-income and middle-income countries like India, postdischarge skilled nursing facilities are at a very nascent stage and largely underequipped in terms of infrastructure, skilled nursing and physician staff to manage complicated patients. Hence the responsibility of management of such patients lies largely with their families. We present a case where a 26-year-old man with Duchenne Muscular Dystrophy who became ventilator dependent following major surgeries was weaned off his ventilator and rehabilitated back to his prehospital state. This was done at his home with visiting nurses and rehabilitation services under telemedicine supervision by a critical care specialist. Use of telemedicine services could be a viable and cost-effective option to ensure adherence to evidence-based medicine and standardisation of care in resource limited countries such as India.
Keyphrases
- healthcare
- mental health
- end stage renal disease
- primary care
- duchenne muscular dystrophy
- newly diagnosed
- emergency department
- ejection fraction
- chronic kidney disease
- palliative care
- machine learning
- quality improvement
- prognostic factors
- patient reported outcomes
- acute respiratory distress syndrome
- cardiac arrest
- intensive care unit
- pain management
- mechanical ventilation