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Augmenting prehospital care
  1. Yuval Glick1,2,
  2. B Avital3,
  3. J Oppenheimer3,
  4. D Nahman3,4,
  5. L Wagnert-Avraham3,
  6. A Eisenkraft3,
  7. L Dym5,
  8. D Levi1,
  9. A Agur1,6,
  10. B Gustus1,7 and
  11. A Furer1,8
  1. 1 Medical Corps, Israel Defense Forces, Ramat-Gan, Israel
  2. 2 Orthopedic Department, Assuta Ashdod Hospital, Ashdod, Israel
  3. 3 Institute for Research in Military Medicine, The Hebrew University of Jerusalem and Israel Defense Forces Medical Corps, Jerusalem, Israel
  4. 4 Department of Internal Medicine ‘A’, Hadassah University Hospital, Jerusalem, Israel
  5. 5 Obstetrics and Gynaecology Division, Soroka Medical Centre, Beer Sheva, Israel
  6. 6 Neurosurgery Department, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
  7. 7 Pediatric Department, Asaf Harofe Hospital, Zerifin, Israel
  8. 8 Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
  1. Correspondence to Dr A Furer, Medical Corps, Israel Defense Forces, Ramat-Gan 01215, Israel; furera{at}


Introduction 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.

Methods 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.

Results 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).

Conclusion 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.

  • augmented reality
  • telementoring
  • chest thoracotomy
  • prehospital

Data availability statement

Data are available on reasonable request.

Statistics from

Data availability statement

Data are available on reasonable request.

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  • Contributors AF and YG conceived the study. BA, JO and AF designed the trial. BA, JO and DL undertook recruitment of participants. BA, JO, YG, DL, LW-A, AA, BG and AF conducted the trial and collected the data. YG and AF conducted quality control. YG, DN and AE provided statistical advice on study design and analysed the data. YG, BA and AF drafted the manuscript and all authors contributed substantially to its revision. AF takes responsibility for the paper as a whole.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.

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