Background: At our Level I trauma center, residents perform the initial evaluation of hand emergencies. Infrequently, injuries are underestimated and appropriate care delayed. This study investigates whether teleconsultation utilizing a digital camera phone helps minimize errors in patient management.

Methods: In a 3 month prospective study, hand consults are evaluated by the resident, who formulates a treatment plan and communicates this to the attending. Using the camera phone, images of the hand and x-rays are emailed to the attending for review. Any modification in the resident's plan is noted.

Results: The senior author covered 18 days of hand call. 22 patients required emergent evaluation. 86% of the patients had traumatic injuries and 14 % had non-traumatic hand emergencies. The resident's plan was changed in 2 cases (9%) after image review. One patient underwent emergent exploration of a forearm laceration with a vascular injury. In another patient, a hand abscess was drained. Attending in-house exam did not affect management decisions initially based on image review.

Conclusion: Teleconsultation with a camera phone is a simple, effective tool in minimizing potential management errors that result from resident inexperience.