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gadgets shown in Figure 3.6 which is worn by the paramedic may not be continuously accessible. Tall structures might leave
no LOS path along the way from the scene of the accident to the hospital or near the scene of the accident Based on Chapter 2
there are a few problems to think about. The most ideal ap- proach to guarantee network coverage is by analyzing the areas
serviced by a particular hospital and develops a database for ground elevation which basically comprises of a computer to-
pography map. The main function of the computer topography map is to gather data about the surrounding terrain to model the
effects of trees and buildings in different areas on the communi- cation link with the ambulance. Any given location z at a spe-
cific x, y position of the area represents the relative elevation of the ground above a fixed reference point for example, the
rooftop of an elevated structure. A detailed database for the points x, y, and z might be seen as a grid for the whole cover-
age region. The topographic database need to contain all the in- formation about the terrain of all the areas that a particular
hospital serves so that whichever place the ambulance goes it will be connected. This communication link will require a high
level of accessibility and reliability whereby a delay is normally not an issue. However, transmission needs to be error free since
data of a patient not need reach the hospital in real time. Besides that, re-transmission of information is never a problem because
if the information is corrupted or lost, it could be re-sent once more. Re-transmission ensures successful information gathering
but at a delayed time frame. Heavy downpour is one of the main factors that cause severe accidents. Actually rain increases the
probability of an accident; it likewise influences the reliability and functions of radio connections. Rain causes problems such
as mainly attenuation and depolarization. Attenuation will weaken the strength of the signals which causes a decrease in
coverage area. Depolarization will affect wireless link which uses both horizontal and vertical polarization signals. Depolari-
zation causes the two signals to intercept with one another and inevitably produce no signal at all. Figure 2.8 shows how criti-
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cal this problem is as the extent of rain attenuation depends on the intensity of the rain. A heavy downpour can influence the
outdoor wireless networks that operates in an area.
Figure 3.6 A well-equipped paramedic assisted by technology FONG et al 2011
We can observe the impact of a rainfall of 0 mmhr and 120 mmhr on 10 GHz and 5 GHz signals. From Figure 2.9, we see
that a horizontally polarized signal is severely influenced by rain. Hence, depolarization will finally trigger off a phase shift
to as much as 90
◦ results the causes horizontally polarized sig- nal intercepting the vertically polarization signal. As the two
signals intercept, they join together and adequately contra one another. The entire network is a crucial factor for the telemedi-
cine system since it provides a solid interface between the per- sonnel’s working on site of incident and the hospital. Fong
2005b has suggested in her research that generally when licens- ing of radio frequencies allows, a lower frequency of 10 GHz or
below ought to be used for tropical regions whereby frequent rainfall level of over 20 mmhr. is often possible. In general,
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any range between 25 and 40 GHz ought to be utilized for im- proving the network performance and staying away from spec-
trum congestion.
3.2.4 Accident and Emergency AE
Surgeons in the Accident and Emergency AE unit can get an exceptional decent idea regarding the condition of the victim
when the ambulance arrives since data indicating the degree of injury suffered by the victim during an accident is sent to the
hospital together with the vital body signs. The electronic pa- tient record provides immediate patient medical history. Even
though the bene
fits of telemedicine technology to the AE unit personnel is clear, there are still various matters to be managed.
Prior work by Benger 2001, guler et al 2002, noland et al 2004 discovered various possible matters which emerge from
the development of service capabilities. Benger has recorded are various human factors like reliability, and convenience and
the issue of incorporating telemedicine technology into current practices. Medical practitioners and supporting staff are obligat-
ed to be clear regarding the system in terms of what it conveys and how it can be fully used. Possibly this involves training to
guarantee data conveyed by the telemedicine framework is rightly deciphered. Since linking to a copyright framework
might incur issues of compatibility and interoperability, inte- grating with an existing medicinal framework might likewise
require exceptional consideration. Even though Tachakra 2006, duchesne et al 2008, giakoumaki et al 2010 has re-
ported that there are no recognizable interference between the telemedicine transmitting gadgets and sensitive medical instru-
ments in AE unit has been traced. Telemedicine is equipped to provide vital data of a victim before his or her arrival at the
hospital. Vital signs like heart beat and breathing, pulse oxyme- try
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ଶ
and arterial blood oxygen pressure ܱܲܽ
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lev- els, diastolic arterial blood pressure DABP, images of injury
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can be made accessible and updated as the patient arrives at the hospital. Despite the fact that an extensive variety of data could
be sent, most of the information send are not large. Hence, channel bandwidth is not an issue. Moreover, there are a few
systems that support live video conferencing but may require an information transmission rate of more than 1 MBs.
3.2.5 The Authority
Privacy is an important matter for authorities concerned with any applicable lawsuit which demand for damages involving
security breach as e-health involves constant supervision of the patients. Thus, the usage of telemedicine may be influencing
liability issue. Usage of telemedicine application that crosses state boundaries can be involved in regulatory issues if the
states use diversified by laws and licensing regulations. Initial setting up cost and shortage of funds may likewise be an imper-
ative issue that constrains the use of telemedicine for AE as officials in-charge might not be aware of the cost benefits in
spite of the fact that valuable time can be saved in handling an accident victim and eventually save a life. Officials in charge
normally make decisions from a business perspective; whatever funds invested can give high returns within a speci
fied timeframe. Thus, the officials in charge have to be made aware
of the benefits of telemedicine applications. Normally, it is not that difficult to overcome technological challenges compared to
obtaining the endorsement from the government. Setting up a complete networking system for supporting emergency cases
might require the co-operation from different sectors mentioned in this section. Additionally, the officials in charge might view
the time required to provide training for medical professionals of various capabilities as time consuming. Even though, the
long term benefit of saving lives is self-evident; gaining finan- cial support from the authorities concerned and the required
time investments are issues to be dealt with seriously.
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3.3 Remote Recovery
Wireless telemedicine enables treatment to be given practically from anyplace; at the sea, on land and even in the air. Mchugh
1997 stated that commercial airlines had started linking their aeroplanes to MedLink which is a service that offers healthcare
support when the plane is in the air. Medlink provides essential life support service to train airline crews to give basic emergen-
cy treatment and diagnose a medical emergency to decide whether emergency landing is needed for immediate medical
treatment. This technology enables better time and cost man- agement by the airline industry which had to be incurred by
making an impromptu landing to drop off passengers who actu- ally do require quick medicinal attention. Through video con-
ferencing, medical professionals from any nations can offer continuous medicinal counseling to airline crews who may not
have any related training in healthcare. It is just a matter of providing suggestions on actions that need to be taken. In addi-
tion, telemedicine can retrieve a passenger’s electronic patient record so that any existing medicinal issues about that passenger
will be known. Besides, rendering help to patients who are in the plane, telemedicine ensures recovery and treatment accessi-
ble from practically anyplace. Remote recovery frequently in- cludes quick disclosure of the victims actual whereabouts.
Moreover any potential treat to the rescue team from the victim can be determined earlier by using telemedicine applications to
avoid from placing the rescue team in dangerous situations. Remote recovery aid in these circumstances through telemedi-
cine is made possible by technology. We shall examine 3 cir- cumstances whereby telemedicine regularly serves to spare lives
of ordinary layman and medical experts who endanger their own lives in order to save others.
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3.3.1 At Sea
Maritime rescue is very demanding because cellular communi- cation networks do not function at sea. Satellite signal is the on-
ly communication option that can be used at the oceans. Even though most modern ship has high technologically advanced
GPS, communication might fail at times as unexpected thing can happen. The ship can sink or lost power, the individual who
need to be rescued may be thrown overboard and GPS commu- nication will fail. The development in technologies enables the
rescue and recovery task to be done hassle free compared to be- fore. Locating an individual in the big ocean is the crucial for
the rescue operation but by the use of video extraction technol- ogy with high resolution makes the task easier to handle. Strate-
gic coordination between the rescue boats, control centre and rescue helicopter are important and receive necessary support in
real time as the waves may shift a person who need to be saved to new location. Satellite communication becomes the only op-
tion as need to cover the vast area of the ocean. Satellite signals use millimeter wave in GHz magnitude which are incapable for
detecting sunken objects and ship. This was due to the absorp- tion of satellite frequencies in the ocean water. Underwater
communication is much more challenging than air communica- tion. Underwater communication is accomplished by acoustic
waves which travel 5 times faster in water than air. The study of acoustic waves was conducted back in 15
th
century; acoustic wave frequency has a range lower and average between 10 KHz
to 20 KHz. This lead to the reasons why the acoustic waves are slower in the air and data transmission will be slower. Other
factors that cause the underwater communication to be prob- lematic are narrow bandwidth and high variation of multipath.
