Augmented Reality for extremity hemorrhage training: a usability study.

Introduction: Limb massive hemorrhage is the first cause of potentially preventable death in trauma. Its prompt and proper management is crucial to increase the survival rate. To handle a massive hemorrhage, it is important to train people without medical background, who might be the first responders in an emergency. Among the possible ways to train lay rescuers, healthcare simulation allows to practice in a safe and controlled environment. In particular, immersive technologies such as Virtual Reality (VR) and Augmented Reality (AR) give the possibility to provide real time feedback and present a realistic and engaging scenario, even though they often lack personalization. Methods: This work aims to overcome the above-mentioned limitation, by presenting the design, development and usability test of an AR application to train non-experienced users on the use of antihemorrhagic devices. The application combines a Microsoft Hololens2 headset, with an AR application developed in Unity Game Engine. It includes a training scenario with a multimodal interactive system made of visual and audio cues, that would adapt to user's learning pace and feedback preference. Results: Usability tests on 20 subjects demonstrated that the system is well tolerated in terms of discomfort and workload. Also, the system has been high rated for usability, user experience, immersion and sense of presence. Discussion: These preliminary results suggest that the combination of AR with multimodal cues can be a promising tool to improve hemorrhage management training, particularly for unexperienced users. In the future, the proposed application might increase the number of people who know how to use an anti-hemorrhagic device.