An evaluation of trauma team leader performance by video recording.

BACKGROUND: Team leader performance in trauma resuscitations was assessed using a published system to assess the utility of video recording and to assess 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, an emergency medicine registrar in eight and a surgical registrar in five. The mean team leader score was 68.5 +/- 8.5 (range 45-78, maximum possible 80). The average time to primary survey completion was 3.3 +/- 1.7 min, second phase of resuscitation up to and including chest radiography 14.1 +/- 8.5 min, to completion of secondary survey and announcement of overall plan 30 +/- 20 min. Frequent deficiencies are documented. Problems with videotaping included forgetting/lack of motivation to start taping, forgetting to turn on the sound, difficulty discerning size of cannulae and logistical problems with only one cubicle outfitted for videotaping. Advantages included lack of intrusion into the resuscitation, increased vigilance by team members aware of the possibility of taping, ability to assess tapes at leisure and 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 issues have not proved to be a barrier to the use of the technique. A reliable method of starting taping is needed.