Telemedicine Devices in Prehospital Trauma Care: A Scoping Review of Telemedical Actions, Clinical Utilities and Implementation Barriers.

Device-enabled telemedicine is increasingly used in prehospital trauma, but reported workflows remain heterogeneous across operational settings, device types, and study designs. A workflow-oriented synthesis is needed to clarify which telemedical actions are being evaluated, what device categories enable them, what clinical utilities are reported, and which implementation barriers recur across studies. To map device-enabled telemedicine in prehospital trauma by linking telemedical actions, enabling device categories, reported clinical utilities, and implementation barrier domains. We conducted a scoping review following the Arksey and O’Malley framework and PRISMA-ScR reporting guidance. Four databases were searched for peer-reviewed primary studies published from 1 January 2010 to 1 July 2025. Eligible studies evaluated prehospital trauma workflows in which a device-enabled telemedical function informed triage, diagnosis, monitoring, or treatment decisions. Using inductive content analysis, we mapped included studies to a four-layer framework of telemedical actions, device categories, clinical utilities, and implementation barriers. Twenty-two studies were included. Most evaluations were simulation-based (15/22, 68.2%). Within the retrieved evidence base, most explicitly described telemedical workflows were synchronous (20/22, 90.9%), whereas asynchronous and hybrid functions were less frequently represented. Telemedical actions clustered around remote consultation and telementoring, remote image acquisition with remote interpretation, algorithm-supported triage, and remote physiological monitoring. Reported utilities most often aligned with diagnostic and triage impact and with system coordination and access. Common and overlapping barriers included evidence maturity gaps, connectivity and technical robustness, usability and training burden, governance and system readiness, and operational context constraints. The evidence base for prehospital trauma telemedicine remains early-stage and is dominated by simulation studies, with limited implementation-ready evaluation. An action-oriented evidence map clarifies the telemedical pathways most often studied and the recurrent barriers to translation, suggesting that future progress will depend on real-world evaluations of workflow resilience and implementation readiness rather than device capability alone.