Army medics deployed to remote or austere locations can face challenges when caring for injured Soldiers. In an effort to provide medical care guidance and recommendations by senior, experienced critical care providers to medics in tough situations a new project called Virtual Critical Care Consultation, or VC3, has been underway for the last several months.

According to the Lt. Col. (Dr.) Jeremy Pamplin, medical director of the U.S. Army Institute of Surgical Research Burn Center Intensive Care Unit and Chief of Clinical Trials, the VC3 project is designed to provide a low-cost, simple tele-monitoring system to inexperienced providers caring for critically ill patients and improve patient outcomes.

"The other potential user would be a small Army community hospital that doesn't have critical care resources like critical care doctors, nurses or trauma surgeons," said Pamplin. "For instance, a patient arrives at the community hospital but is not critically ill at the time. The providers may be on the fence as to how to care for the patient. Should they transport the patient to a larger hospital with critical care capabilities or admit the patient and observe him for a while? In this kind of environment, the staff could use the VC3 to get some recommendations and guidance."

The VC3 project is being funded by the U.S. Army Medical Department Advanced Medical Technologies Initiative as a performance improvement program. The project was started in late 2015 and has been used by various Special Forces units during field training exercises. Pamplin said that the feedback from the personnel involved the training exercises has been very positive.

"Deployed medics will be able to pick up the phone and talk to a critical care provider while caring for a critically ill patient has provided them tremendous confidence and reassurance," he said.

To help identify other current technology that can be used immediately or within the next six months, the San Antonio Military Medical Center at Fort Sam Houston, Texas, hosted a VC3 "Device Day" where several vendors showcased existing technology to determine if it could support the project. Pamplin, along with Air Force Capt. (Dr.) Jeffrey DellaVolpe, a trauma surgeon at SAMMC, were among the key participants who tested the devices simultaneously with another group at Fort Bragg, North Carolina.

"A program like VC3 has the potential to be an indispensable tool to both deployed medics as well as to hospitals without robust critical care staff," said DellaVolpe. "While the military currently has a shortage of critical care providers, it unfortunately does not have a shortage of critically ill patients. VC3 allows the expertise that exists at SAMMC to be at the fingertips of a provider virtually anywhere in the world."

Pamplin explained that the platform that they are looking for should be easy to use without too many distracting features.

"Video teleconferencing, imaging and continuous monitoring capabilities are nice to have, but not necessary in most circumstances," explained Pamplin. "Technology can distract from patient care. One of the things that we've learned from the field training exercises is that if we can get photos ahead then we can provide the right clinical advice to best support the clinician on the ground."

Pamplin added that the most useful photos are those of the care environment, the actual flowsheet that the clinician is using to care for the patient, the kit being used, and the wound.

"If we can get a better understanding of the clinical scenario then we can provide a more robust consult," said Pamplin. "The less distractions that there is on both ends means that we can provide better patient care to the wounded warfighter."