also handled by SAMU centres in Paris, Lisbon and Toulouse. A recent study identified three major barriers to adoption of telemedicine in emergency and critical care units. They include: Regulatory challenges: related to the difficulty and cost of obtaining licensure across multiple states, malpractice protection and privileges at multiple facilities Financial barrier: lack of acceptance and reimbursement by government payers and some commercial insurance carriers, which places the investment burden squarely upon the hospital or healthcare system. Cultural barriers: occurring from the lack of desire, or unwillingness, of some physicians to adapt clinical paradigms for telemedicine applications. Emergency Telehealth is also gaining acceptance in the United States. There are several modalities currently being practiced that include but are not limited to TeleTriage, TeleMSE and ePPE. An example of telehealth in the field is when EMS arrives on scene of an incident and is able to take an EKG that is then sent directly to a physician at the hospital to be read. Therefore, allowing instant care and management. Telenursing Telenursing refers to the use of telecommunications and information technology in order to provide nursing services in health care whenever a large physical distance exists between patient and nurse, or between any number of nurses. As a field it is part of telehealth, and has many points of contacts with other medical and non-medical applications, such as telediagnosis, teleconsultation, telemonitoring, etc. Telenursing is achieving significant growth rates in many countries due to several factors: the preoccupation in reducing the costs of health care, an increase in the number of aging and chronically ill population, and the increase in coverage of health care to distant, rural, small or sparsely populated regions. Among its benefits, telenursing may help solve increasing shortages of nurses; to reduce distances and save travel time, and to keep patients out of hospital. A greater degree of job satisfaction has been registered among telenurses. In Australia, during January 2014, Melbourne tech startup Small World Social collaborated with the Australian Breastfeeding Association to create the first hands-free breastfeeding Google Glass application for new mothers. The application, named Google Glass Breastfeeding app trial, allows mothers to nurse their baby while viewing instructions about common breastfeeding issues (latching on, posture etc.) or call a lactation consultant via a secure Google Hangout, who can view the issue through the mother's Google Glass camera. The trial was successfully concluded in Melbourne in April 2014,