Utilizing Intraoperative Trauma Video Review to Assess Operating Room Preparedness for Emergent Trauma Surgery Cases

One of the most critical aspects of the transition from ED to operating room (OR) and subsequent timely initiation of surgery is the preparedness of the OR, but this is difficult to assess owing to a lack of available data. Using audiovisual recordings of trauma operations, we sought to describe the variability in OR preparedness for emergent trauma surgical cases.

We used audiovisual files from consecutive trauma cases between June to July of 2024. Using a REDCap data collection instrument based on readiness prompts from our institutional Trauma Anesthesia Checklist, we assessed item preparedness before patient arrival concerning various essential equipment items. Additionally, we examined the impact of patient hemodynamics on the preparedness of the anesthesia team.

We analyzed 53 cases over the 8-wk period. Median room setup time was 9.4 min (interquartile range [IQR] 4.8-16.1), and this was not significantly different based on the presence of hypotension (9.38 [IQR 5.21-15.14] versus 9.43 [IQR 4.70-17.58], P = 0.76). Overall equipment preparation rates were high, but we found opportunities for improvement in the preparation of other equipment, notably patient warmers and video laryngoscopes.

Video review programs represent an opportunity to measure preparedness for emergent trauma surgical cases. While we found that preparedness was excellent in some domains, we identified several important areas for improvement. These insights will be used to inform future quality improvement action plans and act as proof of concept for the role of video review in surgical QI initiatives.