In this paper, we propose a solution for video transmission over a low-bandwidth network that enables a physician to take in charge of remote trauma patient. We propose and analyze a method based on an H.264 compression scheme that relies on transmitting high-quality video of a moving and dynamic region of interest while scarifying quality in the background. Our method is motivated by the problem of limited bandwidth usually encountered in air-to-ground communication channels. We propose to use a region of interest with smoothed edges to increase the video quality of the transition between the regions of various qualities. The moving region of interest, covering the torso and the head, is segmented and tracked by using the skeleton information provided by a Kinect camera. Our proposed compression scheme respects the realtime, low-complexity, and interoperability constraints. We have analyzed the results of our method obtained with various bit rate targets and have shown that a visual assessment of a patient is achievable over very low bandwidth. INDEX TERMS Video compression, telemedicine, region of interest, body skeleton, H.264, emergency medical services.