Story at a glance
- A construction worker recently collapsed at a construction site in Florida.
- The safety officer called an emergency doctor using their telehealth service and the doctor walked them through using a defibrillator.
- The worker was taken to a local hospital and survived.
Telehealth and telemedicine have been a long time coming, but their ubiquity has accelerated during the coronavirus pandemic.
Recently in Florida, when a construction worker collapsed in the parking lot of their construction site, their telehealth doctor was on standby ready to assist until an ambulance arrived. And that may have saved his life.
About a year ago, the Moss Construction site set up telemedicine services with JobSiteCare, founded by emergency physician and former Naval officer Dan Carlin. JobSiteCare sets up a phone line that connects each construction site with a dedicated full-time physician, nurse practitioner and administrators. Workers at the site can call whenever there is an accident or injury. Because the construction sites are typically in isolated areas, calling a doctor first can, in some cases, help avoid a long trip to the nearest hospital.
On the day of this incident in March, Carlin was on-call. When he heard that one of the workers was passed out in the parking lot, he quickly instructed the safety officer on the other end of the line to switch the phone call to a video call over FaceTime and bring him to the scene. “And I made eye contact, I said, ‘Hold up the phone. Let me talk to the guy doing CPR,’” says Carlin.
One of their colleagues was performing CPR on the worker, who wasn’t responding and didn’t seem to have a pulse. Carlin asked how long they had been doing CPR and where was the defibrillator, a device that can send electric shocks to key points in the body to try to get the heart pumping again. “And they looked at me like, ‘Oh no, oh my gosh, we should have got the defibrillator,’” says Carlin. Send your fastest to run and get it, he told them.
Carlin helped them get the defibrillator set up. “The defibrillator says, ‘Don't touch the patient. Analyzing rhythm. Don't touch a patient.’ And this usually takes about 10 seconds,” Carlin told Changing America. “I can sense I'm in community with these guys and we're waiting to hear what it has to say. And the defibrillator says, ‘Shock advised. Charging.’” The person doing CPR asked if they should shock him and Carlin said yes, but told them all to back away from him first.
They pushed the button to send the shock. “Nothing immediately happens but about five to 10 seconds later, he sort of gives this kind of low gasp for breath,” says Carlin. “And about 10 seconds after that the EMF rig arrives in the parking lot, and a paramedic comes running over.” The paramedic checks his neck for a pulse and doesn’t feel anything, but then checks another artery in the groin fold and finds a slow pulse there. The patient gets loaded into the ambulance which gets intercepted by a helicopter that takes him the rest of the way to a hospital in Tallahassee.
The man survived and later returned to the job site to thank the individual who performed CPR on him and find out if he could return to work.
Because the construction site location was far from a hospital, it can take a long time for an ambulance to arrive. “I know they drove very fast. They did a great job getting there, but I think it was probably around 20 minutes or so,” says Carlin. Their telehealth services were meant for a situation like this, adds Carlin. The doctors can help the people on the ground do what's necessary in the time before the paramedics arrive on the scene. Although the construction workers were trained in CPR and knew about the defibrillator, they aren’t experienced in emergency situations like an emergency doctor.
It so happens that Carlin was the first person to save a life over the internet, back in 1998, when he provided care over email to a lone Russian sailor at sea, according to People Magazine. Following Carlin’s instructions, the sailor was able to perform surgery on himself and recover from internal injuries.
Source: People Magazine
Carlin has been a proponent of telehealth for decades and sees this recent incident as a sign of the potential for what it can do to close gaps in health care, especially urgent care. “It's just an extension of expertise we already have,” says Carlin. “There's a huge role for [it]. We've gotta unburden the healthcare system somehow.”