Introduction: Emergency medical technicians in Japan have experienced difficulties in identifying
hospitals that will accept patients with severe finger injuries. We developed and managed a system
named Interactive Teletriage using mobile phone photos to aid efficient patient transportation. The aim
of this study was to investigate features related to the transportation of patients with severe finger
injuries and to evaluate the feasibility of this system.
Materials and methods: We prospectively analysed data from the medical association of Aichi Prefecture
and the Nagoya City Fire Department in Japan. We investigated features related to the transportation of
474 patients with severe finger injuries in Nagoya from 2010 to 2013: 100 in 2010, 134 in 2011, 125 in
2012, and 115 in 2013. We began using Teletriage in August 2011 and compared the periods before and
after its implementation.
Results: The time of injury showed two different peaks from 09:00 to 11:00 h and at 13:00 h. The number
of patients injured during each weekday was generally the same, while cases on Saturdays and Sundays
reflected 70% and 47% of the weekday average, respectively. Of the 474 patients, 395 (83%) were accepted
to hospitals after 3 or fewer requests for admission: 160 of 202 (79.2%) before and 235 of 272 (86.4%)
after Teletriage, constituting a significant increase (p = 0.039). Furthermore, the number of patients who
required 4 or more requests significantly decreased after implementation of Teletriage (p = 0.039):
42 patients (20.8%) before and 37 (13.6%) after Teletriage. Our data showed that as the number of
requests until final determination increased, the transportation period increased. Furthermore, the mean
transportation period significantly decreased from 22.3 min before to 18.1 min after Teletriage
(p = 0.021). As the number of requests until final determination increased, the proportion of patients
transported to Level I and II hospitals decreased; conversely, the proportion of patients transported to
Level III, IV, and V hospitals increased.
Conclusions: Our results indicated that the implementation of Teletriage has the potential to ease the
problem of emergency medical transportation for those with severe finger injuries.