Brendan William Munzer, Mohammad Mairaj Khan, Barbara Shipman, Prashant Mahajan
8 min
This paper presents a scoping review aimed at evaluating the current state of augmented reality (AR) applications within the context of emergency medicine. Despite the rapid growth of AR technology, its specific role in acute care delivery and provider training remains in the early stages of investigation. The authors conducted a systematic search across major medical and scientific databases to identify literature that could be applied to the unique, high-pressure environments of emergency departments and prehospital care.
The review identified 24 relevant articles, which were categorized into three primary functional areas:
Emergency medicine relies on rapid, accurate decision-making often performed under extreme time constraints. Current technology, such as stationary computer monitors, can act as a distraction. AR offers a paradigm shift by delivering essential, contextual information directly into the provider's line of sight. While the hardware—including battery life, ergonomic comfort, and connectivity—continues to mature, the potential for AR to reduce medical errors and expand the reach of specialist expertise via telemedicine makes it a critical area for future clinical research.
BACKGROUND: Augmented reality is increasingly being investigated for its applications to medical specialties as well as in medical training. Currently, there is little information about its applicability to training and care delivery in the context of emergency medicine. OBJECTIVE: The objective of this article is to review current literature related to augmented reality applicable to emergency medicine and its training. METHODS: Through a scoping review utilizing Scopus, MEDLINE, and Embase databases for article searches, we identified articles involving augmented reality that directly involved emergency medicine or was in an area of education or clinical care that could be potentially applied to emergency medicine. RESULTS: A total of 24 articles were reviewed in detail and were categorized into three groups: user-environment interface, telemedicine and prehospital care, and education and training. CONCLUSIONS: Through analysis of the current literature across fields, we were able to demonstrate that augmented reality has utility and feasibility in clinical care delivery in patient care settings, in operating rooms and inpatient settings, and in education and training of emergency care providers. Additionally, we found that the use of augmented reality for care delivery over distances is feasible, suggesting a role in telehealth. Our results from the review of the literature in emergency medicine and other specialties reveal that further research into the uses of augmented reality will have a substantial role in changing how emergency medicine as a specialty will deliver care and provide education and training.
Sam: Only one study was identified as directly related to emergency medicine. The rest covered potentially transferable applications. That’s the central constraint: relevance to emergency work is not the same as testing in an emergency department.
Alex: Give me a concrete example where that transfer makes sense, while keeping the distinction visible.
Sam: One study placed a digital outline of a neck vein and nearby artery over a manikin. Learners used it for central venous catheterization: placing a line into a large vein. Participants found it easy and enjoyable, and reported that it didn’t interfere with their technique.
Alex: So it supports usability in a training task. It doesn’t tell us whether the overlay makes that procedure safer in patients.
Sam: That’s the boundary. The review organizes these applications around interfaces, remote care, and education. Across those areas, promising demonstrations often answer “Can this work?” rather than “Does this improve care?”
Alex: Were there comparisons that went beyond whether people liked using the system?
Sam: In a simulated pediatric resuscitation, a headset displayed the Pediatric Advanced Life Support algorithm. Compared with participants not using augmented reality, users made fewer errors in medication doses and defibrillation doses—the electrical shocks used in resuscitation. Time to the initial shock did not increase.
Alex: That addresses a useful trade-off: fewer dosing errors without delaying the initial shock. But it was still a simulated emergency.
Sam: And the review says that study did not discuss headset usability. Another feasibility study reported distracting multiple images, overheating hardware, and difficulty connecting to the internet. Bringing information closer doesn’t automatically make the interface easier to use.
Alex: Remote guidance seems like a different proposition. What does augmented reality add beyond letting an expert watch a video call?
Sam: It can let the expert point within the learner’s view, rather than rely on verbal instructions alone. In one procedural study, a remote attending physician used a cursor to highlight important details. Other systems allowed annotations over the working view.
Alex: Did anyone test whether that kind of guidance could work across a substantial distance?
Sam: A system linked Birmingham, Alabama, with Ho Chi Minh City, Vietnam, to assist neurosurgical procedures. Average communication delay was about 237 milliseconds, with no disruption in transmitted image quality reported. That supports technical feasibility for that connection, not reliable performance everywhere.
Alex: And successful connections are only part of the picture. Did the review include attempts that didn’t work?
Sam: In another report, roughly four in five transmission attempts succeeded with good image quality. So remote assistance was possible, but connection reliability remained a constraint. The authors also identify poor wireless connections as a broader device limitation.
Alex: Emergency care also involves deciding who needs help first. Did the review find evidence for that task?
Sam: It did, in simulated disaster triage: sorting patients by urgency of care. One study compared traditional triage with smart glasses offering an interactive algorithm or remote physician support. Traditional triage was faster, while the smart-glasses approaches were significantly more accurate.
Alex: That isn’t a simple win for the new technology. Speed and accuracy moved in different directions.
Sam: And the exercise was simulated, so it cannot establish the balance of benefits during a real disaster. It does identify a comparison worth testing further. Calling a system useful requires specifying which outcome matters and under what conditions.
Alex: What about education? It seems like a setting where overlays could be useful without immediately carrying the risks of live patient care.
Sam: About half the reviewed articles focused on education and training. Applications included anatomy, procedural practice, and simulated clinical decisions. One airway model showed how changing head position changed the space available for breathing, making otherwise hidden anatomy visible.
Alex: But seeing anatomy more clearly isn’t necessarily the same as learning a procedure better. Did realism have limits?
Sam: Yes. In an ultrasound-guided procedure simulator, participants thought needle placement looked realistic. But there was no tactile feedback, so it did not feel realistic. That separates visual resemblance from the physical experience a learner needs.
Alex: Stepping back, how much confidence should a researcher put in the overall evidence?
Sam: Enough to identify plausible applications, not enough to claim established clinical effectiveness. Most studies were observational and used small groups. Platforms varied, and most studies lacked objective measures of effectiveness. The review offers a landscape, not a pooled estimate of benefit.
Alex: So where does that leave the authors’ ambition to improve emergency care?
Sam: As a research direction. At publication, they found no studies evaluating augmented reality’s effect on patient safety in real time. They call for comparisons with current technology and attention to clinical outcomes, alongside practical issues such as sanitation, battery life, and integration with medical devices.
Alex: Who should read the full document, and where should they start?
Sam: Emergency medicine educators and researchers developing clinical interfaces or remote guidance systems should read it. Start with the Results subsection closest to your task, then read the Limitations. The Future Directions section helps distinguish proposed uses from demonstrated ones. Treat this as a map of an early field, not a current purchasing guide.
Alex: And what should everyone else carry away from that map?
Sam: An interface can bring information closer without proving that it brings better care. This review makes the case for testing augmented reality in emergency medicine—not for assuming the patient benefit.
Alex: Thanks for listening.