A Portable Multi-Stream Telemedicine System for First-Level Emergency Support in Crisis Environments

Abstract

Objective: The Ukrainian Remote Emergency Support Case project (URESC) developed a portable telemedicine system to support layperson first responders in crisis environments through real-time audio-visual consultation with remote medical specialists. Methods: Following a structured requirements analysis involving 66 experts from Ukrainian emergency and clinical settings, the originally “suitcase” container was revised to a mobile “backpack”-based design. The system integrates three simultaneous wireless video streams (scene view, responder communication, responder chest-mount perspective) based on the WebRTC standard, a ruggedized tablet, CE-certified vital sensors, and a 5G mobile router. A webbased client-server architecture enables first responders to initiate a video consultation with minimal interactions. Results: Validation was conducted under realistic simulated scenarios with medical experts participating remotely. WebRTC-native streams performed reliably under variable network conditions; GoPro (RTMP-based) streams exhibited higher latency, identifying a clear path for further optimization. The system demonstrates a viable, cost-effective approach with ruggedized components to structured telemedicine support in resource- constrained environments. Conclusion: URESC has established a technical foundation for portable multi-stream telemedicine systems that enable remote emergency support in crisis environments. Initial validation demonstrated the feasibility of the multi-perspective approach and provides a basis for further field-oriented development and evaluation.