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Trauma video review analysis: Increased provider movement impedes trauma team performance
Bahaa Succar1, Nicole Lunardi1, Kaustubh Gopal1
1Department of Surgery, Division of Burns, Trauma, and Acute Care Surgery, University of Texas Southwestern, Dallas, TX, USA.
Introduction:
Trauma team performance, measured by the non-technical skills scale T-NOTECHS, has been shown to impact patient outcomes. We assess how personnel movements affect non-technical skills and time of resuscitation(TOR) using trauma video review.
Methods:
A prospective study of blunt and/or penetrating trauma activations recorded between May and November 2023 at a Level-I trauma center. Regressions controlling for confounders were used to measure the association between foot traffic and the outcomes of interest1: TOR2 T-NOTECHS score(Smith et al., 2015; Mackenzie et al., 2007; Maiga et al., 2024; Vella et al., 2024; Pucher et al., 2014; Dumas et al., 2020; Succar et al., 2024; Steinemann et al., 2012; Andersson et al., 2012; Conrad et al., 2010; Lies and Zhang, 2015) .5-155-15 RESULTS: We identified 77 trauma activations, with 40 %(n = 32/77) penetrating injuries. There was a median of 17[14-18] individuals at the start of trauma activations. During resuscitations, individuals entered the room a median of 12[8-18] times and exited the room 17[11-22] times. The median TOR was 8[6-10] min and the median T-NOTECHS was 7[6-8]. Regression analysis showed foot traffic was independently associated with increased TOR(β 0.34, p-value <0.01) and worse total T-NOTECHS score(β 0.06, p < 0.01).
Conclusions:
Higher foot traffic is associated with poorer team performance and delays in resuscitation. Future directions should further explore environmental and personal factors that may impede performance metrics.
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