Augmented Reality and Telestrated Surgical Support for Point of Injury Combat Casualty Care: A Feasibility Study

  • Geoffrey T. MillerEmail author
  • Tyler Harris
  • Y. Sammy Choi
  • Stephen M. DeLellis
  • Kenneth Nelson
  • J. Harvey Magee
Conference paper
Part of the Lecture Notes in Computer Science book series (LNCS, volume 10915)


Providing surgical care in remote environments presents a significant challenge. Telepresence and telesurgery have the potential to bridge the gap between definitive care and nonsurgical critical care for prolonged field care scenarios. This feasibility study investigated several key questions regarding the suitability of these technologies for this application. First, what are the technology requirements and minimum specifications for telestration capabilities between a surgical specialist at a Medical Treatment Facility and a remote non-surgeon in a far-forward environment using existing telecommunication systems within the US Army? Second, what training requirements are needed to prepare surgeons and non-surgeons to control lower extremity junctional hemorrhage, and to use associated telestration hardware, software and communications systems? Third, what is the transferability of this training paradigm and technology suite to a wider range of medical care and clinical procedural skills to anticipated future military medical care needs and environments? Our initial feasibility study indicates that telementoring and telestration using augmented reality (AR) systems appears well suited to providing surgical support and training across dispersed groups of medical providers. Forward surgical support using AR and telestration technologies are viable for point of injury surgical support and may be essential to filling this “missing middle” in the Combat Casualty Care continuum. We anticipate that the life and limb saving capabilities supported by this approach will be necessary in future Multi-Domain Battlefield Concept and in cases of remote and dispersed operations.


Augmented reality Telestration Telementoring Modeling Simulation Combat casualty care 



Since the demonstration described in this report, the Army Medical Department’s Advanced Medical Technology Initiative Program has funded a research study for further investigation and development.


The views expressed herein are those of the authors and do not necessarily reflect the official policy of the Department of Defense, Department of the Army, U.S. Army Medical Department or the U.S. Government.

Reference herein to any specific commercial products, process, or service by trade name, trademark, manufacturer, or otherwise, does not necessarily constitute or imply its endorsement, recommendation, or favoring by the U.S. Government.


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Copyright information

© This is a U.S. government work and its text is not subject to copyright protection in the United States; however, its text may be subject to foreign copyright protection 2018

Authors and Affiliations

  • Geoffrey T. Miller
    • 1
    • 2
    Email author
  • Tyler Harris
    • 3
  • Y. Sammy Choi
    • 3
  • Stephen M. DeLellis
    • 4
  • Kenneth Nelson
    • 3
  • J. Harvey Magee
    • 1
  1. 1.Telemedicine and Advanced Technology Research CenterUnited States Army Medical Research and Materiel CommandFort DetrickUSA
  2. 2.Eastern Virginia Medical SchoolNorfolkUSA
  3. 3.Womack Army Medical CenterFort BraggUSA
  4. 4.United States Army Special Operations CommandFort BraggUSA

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