title: Ultrasound-guided central venous access using Google Glass.
abstract: BACKGROUND
  The use of ultrasound during invasive bedside procedures is quickly becoming the standard of care. Ultrasound machine placement during procedures often requires the practitioner to turn their head during the procedure to view the screen. Such turning has been implicated in unintentional hand movements in novices. Google Glass is a head-mounted computer with a specialized screen capable of projecting images and video into the view of the wearer. Such technology may help decrease unintentional hand movements.
  
  
  OBJECTIVE
  Our aim was to evaluate whether or not medical practitioners at various levels of training could use Google Glass to perform an ultrasound-guided procedure, and to explore potential advantages of this technology.
  
  
  METHODS
  Forty participants of varying training levels were randomized into two groups. One group used Google Glass to perform an ultrasound-guided central line. The other group used traditional ultrasound during the procedure. Video recordings of eye and hand movements were analyzed.
  
  
  RESULTS
  All participants from both groups were able to complete the procedure without difficulty. Google Glass wearers took longer to perform the procedure at all training levels (medical student year 1 [MS1]: 193 s vs. 77 s, p > 0.5; MS4: 197s vs. 91s, p ≤ 0.05; postgraduate year 1 [PGY1]: 288s vs. 125 s, p > 0.5; PGY3: 151 s vs. 52 s, p ≤ 0.05), and required more needle redirections (MS1: 4.4 vs. 2.0, p > 0.5; MS4: 4.8 vs. 2.8, p > 0.5; PGY1: 4.4 vs. 2.8, p > 0.5; PGY3: 2.0 vs. 1.0, p > 0.5).
  
  
  CONCLUSIONS
  In this study, it was possible to perform ultrasound-guided procedures with Google Glass. Google Glass wearers, on average, took longer to gain access, and had more needle redirections, but less head movements were noted.
authors.affiliation: University of Arizona College of Medicine-Phoenix, Phoenix, Arizona; Department of Emergency Medicine, Maricopa Medical Center, Phoenix, Arizona.
authors.forename: Teresa S
authors.initials: TS
authors.lastname: Wu
authors.affiliation: University of Arizona College of Medicine-Phoenix, Phoenix, Arizona; Department of Emergency Medicine, Maricopa Medical Center, Phoenix, Arizona.
authors.forename: Christian J
authors.initials: CJ
authors.lastname: Dameff
authors.affiliation: University of Arizona College of Medicine-Phoenix, Phoenix, Arizona; Phoenix Children's Hospital, Phoenix, Arizona.
authors.forename: Jeffrey L
authors.initials: JL
authors.lastname: Tully
mesh_terms: D001291:Attitude of Health Personnel; D002405:Catheterization, Central Venous / Q000379:methods*; D002983:Clinical Competence; D005133:Eye Movements; D005139:Eyeglasses; D005260:Female; D019416:Head Movements; D006801:Humans; D008297:Male; D063731:Mobile Applications; D019095:Point-of-Care Systems; D018084:Ultrasonography, Interventional / Q000379:methods*; D014741:Video Recording
keywords: Google Glass; medical education; simulation; ultrasound; wearable technology