C. A. Liebert1, M. A. Zayed3, J. Tran1, J. N. Lau1, O. Aalami2 1Stanford University School Of Medicine,Department Of Surgery, Division Of General Surgery,Palo Alto, CA, USA 2Stanford University School Of Medicine And Palo Alto Veteran’s Affairs Health Care System,Department Of Surgery, Division Of Vascular Surgery,Palo Alto, CA, USA 3Washington University School Of Medicine,Department Of Surgery, Section Of Vascular Surgery,St. Louis, MO, USA
Introduction: Real-time monitoring of patient vital signs is essential to ensure patient safety during surgical procedures requiring conscious sedation, such as bronchoscopy, endoscopy, chest tube placement, and endovascular interventions. Google Glass, with its novel head-mounted display and controls, provides a hands-free platform for enhanced monitoring of vital-sign parameters, particularly when safe multi-tasking is required and an anesthesiologist is not present.
Methods: In this randomized-controlled pilot study with crossover design, PGY-1 through PGY-5 surgery residents (n=14) at an academic institution participated in two standardized simulated bedside procedure scenarios. Scenario 1 involved thoracostomy tube placement using a SimMan® platform, and Scenario 2 involved bronchoscopy using a hybrid CAE EndoVR/SimMan® platform. Traditional vital sign monitors were available 90º from the operative field during all procedures, and residents were additionally randomized with or without continuous wireless vital sign streaming to Google Glass. Time to recognition of pre-programmed vital sign deterioration was recorded. User feedback was collected by survey after completion of the study.
Results: Live streaming of vital signs to Google Glass resulted in a trend towards earlier recognition of critical vital sign changes in both scenarios. During bronchoscopy, the experimental group used traditional monitors 90.3% less (p=0.003), yet recognized critical desaturation 8.8 seconds earlier than the controls (64.6s vs. 73.4s, p=ns). Similarly, during thoracostomy tube placement, the experimental group spent 70.8% (p=0.01) less time looking away from the procedural field, yet recognized severe hypotension 10.5 seconds earlier than the controls (31.3s vs. 42.8s, p=ns). Additionally, hypotension was less severe at time of recognition in the experimental group (+7.7 mmHg, p=0.08). The majority of participants ‘agreed’ or ‘strongly agreed’ that Google Glass increased their situational awareness (64%), was helpful in monitoring vital signs (86%), was easy to use in the procedural setting (93%), and has potential to improve patient safety (85%). The majority of participants ‘agreed’ or ‘strongly agreed’ that they would consider using Google Glass in their future surgical practice.
Conclusions: This randomized-controlled pilot study demonstrates the utility and feasibility of Google Glass for real-time vital sign streaming. Using Google Glass significantly decreased the amount of time spent looking away from the procedural field. There was a trend towards earlier time to recognition of vital sign deterioration in both scenarios, but the small sample size limits the statistical significance of this finding. This study provides preliminary evidence that the novel head-mounted platform of Google Glass can be used in the clinical setting to enhance procedural situational awareness and patient safety.