SAEM PULSE | MARCH-APRIL 2021
A Picture Is Worth a Thousand Words: Utilizing Smartphone Technology in the Evaluation of ENT Emergencies
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By Seth Lotterman, MD Telemedicine is not a new tool and has been available and used by emergency physicians for some time. For example, many emergency physicians are familiar with the use of teleneurology during the evaluation of patients with neurologic emergencies. However, the COVID-19 pandemic has sped up the adoption of telemedicine in a variety of other settings. Improved infrastructure, such as the advent of broadband wireless and improvements in smartphone camera and video capabilities, along
with HIPAA compliant text messaging applications, have increased the potential capabilities of telemedicine. These innovations allow for transmission of clinically useful images to consultants who are not able to immediately evaluate an emergency department patient at the bedside. Many community emergency departments lack subspecialty coverage and the ability to transmit images with high enough quality to assist in real-time medical decisions can be extremely helpful and may help avoid unnecessary transfers. Recent studies using images obtained
with smartphones demonstrated that the image quality was sufficient to allow for remote attending otolaryngologists to assess nystagmus with the performance of the Dix-Hallpike maneuver to facilitate the diagnosis of benign positional peripheral vertigo (BPPV) and to assess for the presence of a retropharyngeal abscess. In one study, by Shah et al, a smartphone was used to record a patient’s eye movements during the performance of the Dix-Hallpike test and the video was later viewed by attending neuro-otologists, who were able to identify BPPV with 85% sensitivity