Augmented reality based mass casualty incident training system

BACKGROUND Guidelines provide instructions for diagnostics and therapy in modern medicine. Various mobile devices are used to represent the potential complex decision trees. An example of time-critical decisions is triage in case of a mass casualty incident. OBJECTIVE In this randomized controlled cross-over study, the potential of augmented reality for guideline presentation was evaluated and compared with a tablet PC as a conventional device. METHODS A specific Android app was designed for use with Smart Glasses as well as with a tablet PC for presentation of a triage algorithm as an example for a complex guideline. 40 volunteers simulated a triage based on 30 fictional patient descriptions each, with technical support from data glasses and a tablet PC in cross-over trial design. The time to come to a decision and the accuracy were recorded and compared between the different devices. RESULTS A total of 2400 assessments were performed. A significantly faster triage time has been achieved with the tablet PC (12.8 sec) compared to the smart glasses (17.5 sec; P = .001) in total. Considering the difference in triage duration between both devices, the additional time needed with the smart glasses could be reduced significantly in the course (P = .001). In accuracy of guideline decisions, there was no significant difference comparing both devices. CONCLUSIONS The presentation of a guideline on a tablet computer, as well as in the form of augmented reality, achieved good results. The implementation using smart glasses took more time due to a more complex operating concept but could be accelerated in the course of the study after adaptation. Especially in a non-time-critical working area where hands-free interfaces are meaningful, a guideline presentation with augmented reality can already be implemented.

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Technical Support by Smart Glasses During a Mass Casualty Incident: A Randomized Controlled Simulation Trial on Technically Assisted Triage and Telemedical App Use in Disaster Medicine (Preprint)

10.2196/preprints.11939 ◽

2018 ◽

Author(s):

Andreas Follmann ◽

Marian Ohligs ◽

Nadine Hochhausen ◽

Stefan K Beckers ◽

Rolf Rossaint ◽

...

Keyword(s):

Augmented Reality ◽

Mass Casualty Incident ◽

Mass Casualty ◽

Disaster Medicine ◽

Technical Support ◽

Control Group ◽

Smart Glasses ◽

Android App ◽

Triage Algorithm

BACKGROUND To treat many patients despite lacking personnel resources, triage is important in disaster medicine. Various triage algorithms help but often are used incorrectly or not at all. One potential problem-solving approach is to support triage with Smart Glasses. OBJECTIVE In this study, augmented reality was used to display a triage algorithm and telemedicine assistance was enabled to compare the duration and quality of triage with a conventional one. METHODS A specific Android app was designed for use with Smart Glasses, which added information in terms of augmented reality with two different methods—through the display of a triage algorithm in data glasses and a telemedical connection to a senior emergency physician realized by the integrated camera. A scenario was created (ie, randomized simulation study) in which 31 paramedics carried out a triage of 12 patients in 3 groups as follows: without technical support (control group), with a triage algorithm display, and with telemedical contact. RESULTS A total of 362 assessments were performed. The accuracy in the control group was only 58%, but the assessments were quicker (on average 16.6 seconds). In contrast, an accuracy of 92% (P=.04) was achieved when using technical support by displaying the triage algorithm. This triaging took an average of 37.0 seconds. The triage group wearing data glasses and being telemedically connected achieved 90% accuracy (P=.01) in 35.0 seconds. CONCLUSIONS Triage with data glasses required markedly more time. While only a tally was recorded in the control group, Smart Glasses led to digital capture of the triage results, which have many tactical advantages. We expect a high potential in the application of Smart Glasses in disaster scenarios when using telemedicine and augmented reality features to improve the quality of triage.

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Effect the Education of Mass Casualty Incident (MCI) on Knowledge, Attitude, Practice and Satisfaction in Red Crescent Rescuers of Hamadan

Scientific Journal of Hamedan Nursing and Midwifery Faculty ◽

10.21859/nmj-25016 ◽

2017 ◽

Vol 25 (1) ◽

pp. 44-51

Author(s):

Arezo Karampourian ◽

Zohreh Ghomian ◽

Katayoun Jahangiri ◽

Behroz Karkhanei

Keyword(s):

Mass Casualty Incident ◽

Mass Casualty

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Prehospital Triage by Lay Person First Responders: A Scoping Review and Proposal for a new Prehospital Triage Tool

Disaster Medicine and Public Health Preparedness ◽

10.1017/dmp.2021.19 ◽

2021 ◽

pp. 1-11

Author(s):

Wesley D Jetten ◽

Jeroen Seesink ◽

Markus Klimek

Keyword(s):

Scoping Review ◽

Life Support ◽

First Responders ◽

Mass Casualty Incident ◽

Mass Casualty ◽

Mass Casualty Incidents ◽

Lay People ◽

Online Databases ◽

Healthcare Experience ◽

Prehospital Triage

Abstract Objective: The primary aim of this study is to review the available tools for prehospital triage in case of mass casualty incidents and secondly, to develop a tool which enables lay person first responders (LPFRs) to perform triage and start basic life support in mass casualty incidents. Methods: In July 2019, online databases were consulted. Studies addressing prehospital triage methods for lay people were analyzed. Secondly, a new prehospital triage tool for LPFRs was developed. Therefore, a search for prehospital triage models available in literature was conducted and triage actions were extracted. Results: The search resulted in 6188 articles, and after screening, a scoping review of 4 articles was conducted. All articles stated that there is great potential to provide accurate prehospital triage by people with no healthcare experience. Based on these findings, and combined with the pre-existing prehospital triage tools, we developed a, not-yet validated, prehospital triage tool for lay people, which may improve disaster awareness and preparedness and might positively contribute to community resilience. Conclusion: The prehospital triage tool for lay person first responders may be useful and may help professional medical first responders to determine faster, which casualties most urgently need help in a mass casualty incident.

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A call for a global terrorism-related mass casualty incident response research consortium

European Journal of Trauma and Emergency Surgery ◽

10.1007/s00068-020-01572-1 ◽

2021 ◽

Author(s):

Amila Ratnayake ◽

◽

Kirthi Abayajeewa ◽

Samiddhi Samarakoon ◽

Tamara Worlton

Keyword(s):

Mass Casualty Incident ◽

Mass Casualty ◽

Incident Response ◽

Global Terrorism ◽

Research Consortium

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The potential benefits of enzymatic debridement in multi-casualty burns incidents

Trauma ◽

10.1177/14604086211002583 ◽

2021 ◽

pp. 146040862110025

Author(s):

John Kiely ◽

Ibrahim Natalwala ◽

Joseph Stallard ◽

Orla Austin ◽

Umair Anwar ◽

...

Keyword(s):

Intensive Care ◽

Mass Casualty Incident ◽

Mass Casualty ◽

Burn Wound ◽

Post Injury ◽

Wound Debridement ◽

Potential Benefits ◽

Goal Directed Fluid Therapy ◽

Male Patients ◽

Enzymatic Debridement

Bromelain-based enzymatic debridement (ED) is a topical treatment that is growing in popularity for the non-surgical management of burn wounds. Although initially used for small injuries, experience has grown in using it for burns >15% Total Burns Surface Area (TBSA). A household explosion resulted in burns to multiple patients, with four requiring burn wound debridement. This case report demonstrates their management using ED. Four adult male patients were treated with ED, mean age 38.4 years. Their injuries ranged from 5–24% TBSA (mean 14.9%), with a high proportion of intermediate-deep dermal injury to their faces and limbs. Our centre has performed enzymatic debridement since 2016 and all senior burns surgeons and burns intensive care specialists in the team are experienced in its use. We perform enzymatic debridement using Nexobrid™ (Mediwound Ltd., Israel). Three patients were managed on a single theatre list, using ED for their burns at 19, 16 and 23 hours post-injury. One patient had ED of his injuries on intensive care at 18 hours. Patients with >15% TBSA were treated in a critical care setting with goal directed fluid therapy. Through the use of enzymatic debridement we were able to achieve burn debridement for four patients in under 24 hours. While not a true mass casualty incident, our experience suggests that for an appropriately resourced service it is likely to have advantages in this scenario. We suggest that burns services regularly using this technique consider inclusion into mass casualty protocols, with training to staff to enable provision in such an incident.

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A Novel Suture Training System for Open Surgery Replicating Procedures Performed by Experts Using Augmented Reality

Journal of Medical Systems ◽

10.1007/s10916-021-01735-6 ◽

2021 ◽

Vol 45 (5) ◽

Author(s):

Yuri Nagayo ◽

Toki Saito ◽

Hiroshi Oyama

Keyword(s):

Augmented Reality ◽

Motion Capture ◽

Open Surgery ◽

Three Dimensional ◽

Training System ◽

Surgical Skills ◽

Surgical Instruments ◽

Interrupted Suture ◽

Education Environment ◽

Surgical Field

AbstractThe surgical education environment has been changing significantly due to restricted work hours, limited resources, and increasing public concern for safety and quality, leading to the evolution of simulation-based training in surgery. Of the various simulators, low-fidelity simulators are widely used to practice surgical skills such as sutures because they are portable, inexpensive, and easy to use without requiring complicated settings. However, since low-fidelity simulators do not offer any teaching information, trainees do self-practice with them, referring to textbooks or videos, which are insufficient to learn open surgical procedures. This study aimed to develop a new suture training system for open surgery that provides trainees with the three-dimensional information of exemplary procedures performed by experts and allows them to observe and imitate the procedures during self-practice. The proposed system consists of a motion capture system of surgical instruments and a three-dimensional replication system of captured procedures on the surgical field. Motion capture of surgical instruments was achieved inexpensively by using cylindrical augmented reality (AR) markers, and replication of captured procedures was realized by visualizing them three-dimensionally at the same position and orientation as captured, using an AR device. For subcuticular interrupted suture, it was confirmed that the proposed system enabled users to observe experts’ procedures from any angle and imitate them by manipulating the actual surgical instruments during self-practice. We expect that this training system will contribute to developing a novel surgical training method that enables trainees to learn surgical skills by themselves in the absence of experts.

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