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Augmented reality glasses improve adherence to evidence-based intubation practice

Authors Alismail A, Thomas J, Daher NS, Cohen A, Almutairi W, Terry MH, Huang C, Tan LD

Received 16 January 2019

Accepted for publication 6 April 2019

Published 6 May 2019 Volume 2019:10 Pages 279—286


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Dr Anwarul Azim Majumder

Abdullah Alismail,1 Jonathan Thomas,2 Noha S Daher,3 Avi Cohen,4 Waleed Almutairi,1 Michael H Terry,1,5 Cynthia Huang,4 Laren D Tan1,4

1Cardiopulmonary Sciences Department, School of Allied Health Professions, Loma Linda University, Loma Linda, CA, USA; 2Zapara School of Business, La Sierra University, Riverside, CA, USA; 3Allied Health Studies, School of Allied Health Professoins, Loma Linda University, Loma Linda, CA, USA; 4Division of Pulmonary, Critical Care, Hyperbaric and Sleep Medicine, Department of Internal Medicine, Loma Linda University Medical Center, Loma Linda, CA, USA; 5Department of Respiratory Care, Loma Linda University Medical Center, Loma Linda, CA, USA

Background: The risk of failing or delaying endotracheal intubation in critically ill patients has commonly been associated with inadequate procedure preparation. Clinicians and trainees in simulation courses for tracheal intubation are encouraged to recall the steps of how to intubate in order to mitigate the risk of a failed intubation. The purpose of this study was to assess the effectiveness of using optical head mounted display augmented reality (AR) glasses as an assistance tool to perform intubation simulation procedure.
Methods: A total of 32 subjects with a mean age of 30±7.8, AR (n1=15) vs non-augmented reality(non-AR) (n2=17). The majority were males (n=22, 68.7%). Subjects were randomly assigned into two groups: the AR group and the non-AR group. Both groups reviewed a video on how to intubate following the New England Journal of Medicine (NEJM) intubation guidelines. The AR group had to intubate using the AR glasses head mount display compared to the non-AR where they performed regular intubation.
Results: The AR group took longer median (min, max) time (seconds) to ventilate than the non-AR group (280 (130,740) vs 205 (100,390); η2,=1.0, p=0.005, respectively). Similarly, there was a higher percent adherence of NEJM intubation checklist (100% in the AR group vs 82.4% in the non-AR group; η2,=1.8, p<0.001).
Conclusion: The AR glasses showed promise in assisting different health care professionals on endotracheal intubation simulation. Participants in the AR group took a longer time to ventilate but scored 100% in the developed checklist that followed the NEJM protocol. This finding shows that the AR technology can be used in a simulation setting and requires further study before clinical use.

Keywords: intubation, augmented reality, simulation, medical education

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