Ritchie P D, Cameron P A
Emergency Department, The Royal Melbourne Hospital, Victoria, Australia.
Aust N Z J Surg. 1999 Mar;69(3):183-6. doi: 10.1046/j.1440-1622.1999.01519.x.
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.
Fifty trauma resuscitations were videotaped over a 21-month period. Each videotape was assessed by an emergency physician.
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.
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.
在澳大利亚墨尔本皇家墨尔本医院，使用已发表的系统评估创伤复苏中团队领导者的表现，以评估录像的效用及当前创伤的早期处理情况。
在21个月的时间里对50次创伤复苏进行录像。每次录像由一名急诊医生进行评估。
团队领导者在37次复苏中为急诊医生，8次为急诊医学住院医师，5次为外科住院医师。团队领导者的平均得分为68.5±8.5（范围45 - 78，最高可能为80）。完成初次评估的平均时间为3.3±1.7分钟，复苏第二阶段直至包括胸部X线检查为14.1±8.5分钟，完成二次评估并宣布总体计划为30±20分钟。记录了常见的不足之处。录像存在的问题包括忘记/缺乏录像动力、忘记打开声音、难以辨别套管尺寸以及仅有一个配备录像设备的隔间所带来的后勤问题。优点包括对复苏无干扰、意识到可能被录像的团队成员警惕性提高、能够从容评估录像以及团队领导者在非工作时间复苏中的表现。
录像对于评估创伤复苏中团队成员的表现是一种有用的方法。可以识别复苏技术中的不足之处并反馈给相关人员。医疗法律问题并未成为该技术使用的障碍。需要一种可靠的开始录像的方法。
