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

Abstract

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.

Augmented Reality in Emergency Medicine: A Scoping Review

“…Follmann et al compared traditional triaging during a simulated mass casualty event to the use of Smart Glasses through both an interactive triage algorithm app and telemedical support. The study found that while traditional triaging was faster, triaging using both an interactive Smart Glasses app and a physician with triage experience available by telemedicine was significantly more accurate [25].…”

Augmenting prehospital care

“…We sought to investigate this subject in a small preliminary field experiment (Figure 1B, C and D) in which the results were promising. Similarly, Follmann et al examined AR telementoring support in a simulated mass casualty event and showed that triage with telementoring was slower, but significantly more accurate,20 and Carenzo et al found that AR telementoring made disaster triage more efficient 21…”

Triage

“…There are several reasons senior physicians and surgeons are recommended (and found to perform better 6,75 ) over other less highly trained or experienced providers. First, there is some evidence that their knowledge and understanding of triage may be better, 6 but that seems to be a minor component.…”