Medical Corps, Israel Defense Forces, Ramat-Gan, Israel.
Orthopedic Department, Assuta Ashdod Hospital, Ashdod, Israel.
BMJ Mil Health. 2021 Jun;167(3):158-162. doi: 10.1136/jramc-2019-001320. Epub 2020 Feb 20.
The challenging environment of prehospital casualty care demands providers to make prompt decisions and to engage in lifesaving interventions, occasionally without them being adequately experienced. Telementoring based on augmented reality (AR) devices has the potential to decrease the decision time and minimise the distance gap between an experienced consultant and the first responder. The purpose of this study was to determine whether telementoring with AR glasses would affect chest thoracotomy performance and self-confidence of inexperienced trainees.
Two groups of inexperienced medical students performed a chest thoracotomy in an ex vivo pig model. While one group was mentored remotely using HoloLens AR glasses, the second performed the procedure independently. An observer assessed the trainees' performance. In addition, trainees and mentors evaluated their own performance.
Quality of performance was found to be superior with remote guidance, without significant prolongation of the procedure (492 s vs 496 s, p=0.943). Moreover, sense of self-confidence among participant was substantially improved in the telementoring group in which 100% of the participants believed the procedure was successful compared with 40% in the control group (p=0.035).
AR devices may have a role in future prehospital telementoring systems, to provide accessible consultation for first responders, and could thus positively affect the provider's confidence in decision-making, enhance procedure performance and ultimately improve patient prognosis. That being said, future studies are required to estimate full potential of this technology and additional adjustments are necessary for maximal optimisation and implementation in the field of prehospital care.
创伤现场的紧急医疗环境要求医护人员迅速做出决策并采取救生干预措施,而这些决策和干预有时可能是他们缺乏经验的情况下做出的。基于增强现实(AR)设备的远程指导有潜力缩短决策时间,并缩小有经验的顾问与第一响应者之间的距离差距。本研究的目的是确定使用 AR 眼镜进行远程指导是否会影响无经验学员进行开胸手术的表现和自信心。
两组无经验的医学生在离体猪模型中进行开胸手术。一组通过 HoloLens AR 眼镜进行远程指导,而另一组则独立进行操作。观察者评估学员的表现。此外,学员和导师评估自己的表现。
远程指导的表现质量更高,且手术过程没有明显延长(492 秒与 496 秒,p=0.943)。此外,远程指导组学员的自信心明显提高,其中 100%的学员认为手术成功,而对照组只有 40%的学员(p=0.035)。
AR 设备在未来的创伤现场远程指导系统中可能具有一定作用,为第一响应者提供可及的咨询,从而积极影响提供者的决策信心,提高手术效果,并最终改善患者预后。话虽如此,仍需要进一步研究来评估这项技术的全部潜力,并进行必要的调整,以实现该技术在创伤现场急救领域的最大优化和应用。