An evaluation of trauma team leader performance by video recording

Background: Team leader performance in trauma resuscitations was assessed u sing a published system to assess the utility of video recording and to ass ess the current early management of trauma at The Royal Melbourne Hospital, Melbourne, Australia. Methods: Fifty trauma resuscitations were videotaped over a 21-month period . Each videotape was assessed by an emergency physician. Results: The team leader was an emergency physician in 37 resuscitations, a n emergency medicine registrar in eight and a surgical registrar in five. T he mean team leader score was 68.5 +/- 8.5 (range 45-78, maximum possible 8 0). The average time to primary survey completion was 3.3 +/- 1.7 min, seco nd phase of resuscitation up to and including chest radiography 14.1 +/- 8. 5 min, to completion of secondary survey and announcement of overall plan 3 0 +/- 20 min. Frequent deficiencies are documented. Problems with videotapi ng included forgetting/lack of motivation to start taping, forgetting to tu rn on the sound, difficulty discerning size of cannulae and logistical prob lems with only one cubicle outfitted for videotaping. Advantages included l ack of intrusion into the resuscitation, increased vigilance by team member s aware of the possibility of taping. ability to assess tapes at leisure an d team leader performance in after-hours resuscitations. Conclusions: Video recording is a useful method for the: assessment of team member performance in trauma resuscitations. Deficiencies in resuscitation technique can be identified and fed back to those involved. Medico-legal i ssues have not proved to be a barrier to the use of the technique. A reliab le method of starting taping is needed.