When responding to a finger injury, emergency medical
services adopted Teletriage when it was difficult for them to
determine whether the patient should be transported to a highly
specialised hospital. After reaching the patient at the accident
scene or shortly thereafter in the ambulance before leaving, the
EMTs took digital photos of the injured fingers and called us while
simultaneously sending the photographs by Then, we assessed the
necessity for highly specialised treatment such as performing
revascularisation, provided authoritative information, and directed
the ambulance to the most appropriate hospital. In turn, the
EMTs called the recommended hospitals and their doctors directly
following our advice. We may have also accepted the patient
depending on the circumstances. The individuals assessing and
providing the information were hand surgery specialists in the
Department of Hand Surgery, Nagoya University Graduate School
of Medicine. We used mobile phones that could transmit and
receive images with a 3.2 megapixel digital camera. Before
Teletriage program initiation, we collaborated with EMTs to
establish the protocol. Doctors from the Department of Hand
Surgery then provided training to EMTs, giving specific details on
how to most effectively photograph the injury. Our protocol
stipulated taking photos on site giving views of the palmar and
dorsal sides with the patient’s fingers spread as much as possible