Emergency physicians and nurses were trained in telemedicine techniques in two emergency departments, one rural (low volume) and one suburban (high volume). Fifteen patient complaints were selected as appropriate for the study. Of 122 patients who met the inclusion criteria, 104 (85%) consented to participate. They were randomized to control and experimental groups. The suburban emergency physician diagnosed and treated the control patients. Experimental patients presenting to the high-volume emergency department were evaluated and treated by the telemedicine nurse in person and the rural emergency physician via the telemedicine link. Immediately before discharge all telemedicine patients were re-evaluated by the suburban emergency physician. Data collected on each patient included: diagnosis; treatment; 72 h return visits; need for additional care; and satisfaction of patient, physicians and nurses. There were no significant differences (P > 0.05) for occurrence of 72 h return visits, need for additional care or overall patient satisfaction. The average patient throughput time (from admission to discharge) was 106 min for the telemedicine group and 117 min for the control group. Telemedicine was a satisfactory technique for the chosen group of patients in the emergency department and was acceptable to the participants.

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data on a tablet then ED nurses draw 3ml of blood from the subjects. We performed an enzyme-linked immunosorbent assay to quantify PeTH level. AUDIT score below 8 was considered no-risk and score 8 and above were considered at-risk alcohol users. PeTH level below 30 was considered no-risk and level 30 and above were considered at-risk alcohol users. We analyzed data using Kappa coefficient and Pearson correlation coefficient.Results: Our preliminary data of 43 subjects showed Kappa coefficient of 0.13 (Pvalue 0.19). We found a higher Kappa coefficient in female subjects (0.28, P-value 0.08) than male subjects (0.00, P-value 0.48). When we treated AUDIT score and PeTH level as interval variables, the Pearson correlation coefficient was 0.37 (P-value 0.016).Conclusions: With small sample size, PeTH showed a moderate correlation with AUDIT score. Direct alcohol biomarkerds have potential to be our future alcohol screening tool but additional research is warranted.