AN AUDIO-VIDEO SYSTEM FOR AUTOMATED DATA-ACQUISITION IN THE CLINICAL ENVIRONMENT

Objective. Our objective was to develop an audio-video data acquisitio n system that facilitates studying the activities of anesthesia care p roviders in the clinical environment. Methods. Ceiling-mounted miniatu re video cameras, vital sign monitors, and videocassette recorders (VC Rs) were interfaced to digital computers in two patient admitting area s and two operating rooms of a trauma center. This video data acquisit ion system network (VASNET) is simple to operate. Insertion of a video tape activates the system and begins video overlay of updated vital si gns onto the video image every 5 sec. Recorded data is passed via a lo cal area network, allowing remote monitoring of the data acquisition p rocess. To facilitate analysis of the video at a later time, the image , soundtrack, and vital signs data are stamped with the same time code . Each tape is initialized by recording the data file name and wall cl ock time for 30 sec at the start of taping. This initialization enable s comparison of the video recordings with anesthesia, surgical, and nu rsing records. Results. During 2 years of operation, VASNET was used t o record over 100 cases of acute trauma management. Vital signs overla id onto the video image identified when patient monitors were in use a nd providing data. Participants found videotape review useful in asses sing their own performance. VASNET was nonintrusive and acquired data with minimum user interaction. In one operating room, separate from th e trauma center, VASNET was installed to function as a remote monitor, with the option of videotaping. Although users were aware of when vid eotaping occurred, once patient management was underway, the activitie s of the anesthesia care providers did not appear to be influenced by the videocassette recording. Equipment maintenance was not excessive. The most frequent problems were changes to the VCR control settings an d disconnection of the power supply or interface connections. Conclusi ons. Videotapes of the process of anesthetizing and resuscitating trau ma patients provided a record of the activities of anesthesia care pro viders. Video vignettes may be useful training tools. Excerpts from re al scenarios can be incorporated into anesthesia simulators. The sound track and timing of real events from such video acquisition may be use ful in the development of multimedia simulations of trauma patient res uscitation. The data collection may be useful for research into human performance, ergonomics, training techniques, quality assurance, and c ertification of anesthesia care providers in trauma patient management . Potential additional applications of VASNET include remote monitorin g of patients in the operating room, in the intensive care unit, durin g transportation, in hazardous environments, and in the field. Such VA SNET telemetry may facilitate the availability of expert opinions duri ng medical and other consultations.