The terrorist attacks of
September 11, 2001,
inspired a nationwide effort
to improve emergency care
for burn patients. In Arizona,
telemedicine turned that
important concept into reality.
O
n the morning of September 11, 2001, the
Arizona Burn Center in Phoenix was one of
hundreds of hospitals scrambling to get ready for
the thousands of people who would be pulled from
the burning wreckage of the World Trade Center, in
New York.
That was the hope. The reality, of course, is that
almost none of the people who were at their desks
or enjoying breakfast at “Windows on the World”
restaurant ever had a chance of being saved.
But out of that awful day came the nation’s
realization that terrorist attacks and other tragedies
were no longer confined to the rest of the world.
They could happen right here, to us.
middle of the state,” Dr. Caruso says. “We’ve got
a 1,500 – mile radius from where we can take
patients – including California and New Mexico.
Not all burn patients have to be transported to our
center, but either way, we can see what’s going
on even before the helicopter arrives. We can help
with supportive care, and get treatment started
earlier.”
Telemedicine helps determine which patients need
to be transported to the Burn Center.
“A lot of patients still come to us who don’t need
to come here,” Dr. Caruso says. “I can talk to the
other doctor and in some cases we can determine
that the patient can be treated locally, instead
of bringing the patient to us by helicopter, which
costs $10,000 to $20,000.”
And from that came a call to action – from federal
and state governments, the American Burn
Association and others
– to build a system that
“In some cases the
could handle thousands
patient can be treated
of burn patients whenever
locally, instead of
the need occurred.
bringing the patient to us
Dr. Caruso and the Burn
Center’s other surgeons
have telemedicine on
their home computers –
desktop and laptop – so
emergency physicians
at outlying hospitals can
count on 24/7 access to a
burn specialist.
In 2002, the Arizona
by helicopter, which costs
Department of Health
Services asked surgeon
$10,000 to $20,000.”
Daniel M. Caruso, MD,
Daniel M. Caruso, MD,
Flagstaff Medical Center
then director of the
Arizona Burn Center
consults with the Arizona
Arizona Burn Center at
Burn Center about once a
Maricopa Medical Center
month, on average.
in downtown Phoenix, to
come up with a plan to expand the state’s capacity
“Having telemedicine available to us has just
for burn patients. The Burn Center has 45 beds,
revolutionized things,” says Kevin Conn, MD, one
three-fourths of which are usually in use.
of the Flagstaff hospital’s emergency physicians.
The solution, Dr. Caruso and others recognized,
“In a couple of minutes the burn specialists at
was to connect his hospital to those in Tucson,
Arizona Burn Center can see our patient and
Flagstaff, Yuma, and rural communities
recognize the severity of their injuries. Now the
through the Arizona Telemedicine Program. The
Burn Center surgeon can say, ‘Yeah, that guy
“spoke” hospitals were equipped with portable
definitely needs to come down. Get him on a
telemedicine units and, as a result, there are now
helicopter.’ Or the surgeon can say, ‘I need to
110 more burn beds statewide.
see this patient in person, but if her pain is under
control, she can wait to come down in a day or
Dr. Caruso, now head of surgery at Maricopa
two.’”
Medical Center, explains how it works. “Let’s say
St. Mary’s in Tucson gets 10 burn patients. The
For Dr. Conn, who has been with Flagstaff Medical
staff there can take ‘Doc on a Stick’ – a robotic
Center for 12 years, “Burn telemedicine is a very
device that transmits images of patients in outlying
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