Tele Emergency Services in the Himalayas: Operational Challenges Dhavapalani A*, Baskar D*, Ganapathy K**, Arunabh Sarma**, Saroj Thakur**, Premanand S**, Lovakanth N** *Apollo Main Hospital, Chennai & **Apollo Tele Health Services Introduction Himachal Pradesh Tele Health Services Programme, is an initiative to provide access to quality health care services to local communities in Kaza and Keylong. Tele-Emergency services is an important component of this programme. Patients had to travel 250 kms to reach the nearest secondary care hospital, prior to introduction of this service. Ambulance transfers & helicopter evacuations have been reduced   Results Period April 2015 to September 2016 Total cases seen 343/4867 (7.05%) Males 227 Females 116 Significant Cases Under Tele Emergency Services Myocardial Infarction 9 Cardio version through tele-mentoring 3 Thrombolysis through tele-mentoring 1 “Excellent” rating by beneficiaries 82% Non-emergency cases attending emergency OP 52 Materials and Methods Complete emergency set up with 12 lead ECG, Spiro meter, Defibrillator, medications and a console for tele-consultation as per approved JCI protocols Patients in emergency situations connected to Emergency physicians at Apollo Main Hospital, Chennai and through tele mentoring stabilized Local doctor available at the remote center managed the patient as advised by Emergency Physician and provided medications. Emergency Specialist @Chennai demonstrating cardio version on Mannequin during live tele-mentoring Remote Center@ Keylong Tele Emergency Setup @ Keylong Conclusions 24X7 Tele Emergency services are being provided for the first time in the world in isolated mountainous areas. patients shifted to higher center post stabilization Real time Tele ECG References Tele Medicine Services in the Himalayas: Operational Challenges (Ganapahty K, Chandralekha J, Premanand S): http://www.ncbi.nlm.nih.gov/pubmed/?term=Telemedicine+in+the+Himalayas+operational+challenges%5Ball%5D