• Tyler E Harris, Stephen F DeLellis, Jerry S Heneghan, Robert F Buckman, Geoffrey T Miller, J Harvey Magee, William N Vasios, Kenneth J Nelson, Shawn F Kane, and Choi Y Sammy YS Womack Army Medical Center, 2817 Reilly Road, Fort Bragg, NC 28310..
• Womack Army Medical Center, 2817 Reilly Road, Fort Bragg, NC 28310.
• Mil Med. 2020 Jan 7; 185 (Suppl 1): 521-525.

IntroductionThis article presents an emerging capability to project damage control procedures far forward for situations where evacuation to a formal surgical team is delayed. Specifically, we demonstrate the plausibility of using a wearable augmented reality (AR) telestration device to guide a nonsurgeon through a damage control procedure.MethodsA stand-alone, low-profile, commercial-off-the-shelf wearable AR display was utilized by a remotely located surgeon to synchronously guide a nonsurgeon through proximal control of the distal external iliac artery on a surgical manikin. The manikin wound pattern was selected to simulate a rapidly exsanguinating junctional hemorrhage not controllable by nonsurgical means.ResultsThis capability demonstration displayed successful use of AR technology, telecommunication, and procedural training and guidance in a single test pilot. The assisted physician assistant was able to rapidly control the simulated external iliac artery injury on this model. The telestration system used was commercially available for use with available civilian cell phone, wireless and satellite networks, without the need for dedicated high-speed networks.ConclusionsA nonsurgeon, using a wearable commercial on-visual-axis telestration system, successfully performed a damage control procedure, demonstrating the plausibility of this approach.Published by Oxford University Press on behalf of the Association of Military Surgeons of the United States 2020.

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