This project was a demonstration of an augmented reality (AR) forward surgical care system. A sample of six persons, two each of Military physicians (non-surgeons), physician assistants, and special operations medics used a lightweight, rugged, wearable AR display (ODG R-7) with telestration software, bi-directional voice and video, and voice-controlled on-board magnification to receive remote guidance from surgeons across cell networks, army radios, and satcom. Two procedures (four-compartment fasciotomy; anterior exposure of femoral artery) were performed on synthetic-anatomy medical training manikins. The ODG R7’s preserved user peripheral vision to enable tactical situational awareness while using the device.
This technology integration project demonstrated that surgical specialty care can be provided in far forward environments when timely access to in-person surgical care is impossible. The operational concept was to integrate COTS items into existing telecommunication systems within the U.S. Army to create a unique operative platform.
A Mastery Learning Model was developed and employed to train and assess skill performance of both the mentees (non-surgeons) and mentors (surgeons) during the exercise. As an integration project, the effort was not designed to reach statistical significance. Even so, the six students opened 23 of 24 fascial compartments successfully and achieved control of the proximal femoral artery on all of the six test models. The fasciotomy completion rates exceed the success rate that has been reported for attending surgeons in some studies.
This paper will discuss the development of the smart glasses system, the Army-approved training demonstration methodology and outcomes, lessons learned, and the roadmap for development of a fieldable system and best practices for future efforts based on our successful demonstration.
THE VIEWS EXPRESSED HEREIN ARE THOSE OF THE AUTHOR(S) AND DO NOT REFLECT THE OFFICIAL POLICY OR POSITION OFTHE US ARMY MEDICAL DEPARTMENT, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE, OR THE U.S. GOVERNMENT.