Trauma videotape resuscitation conference: a new way to teach trauma care

Do not roll the videotape: effects of the health insurance portability and accountability act and the law on trauma videotaping practices

BACKGROUND

We hypothesized that trauma video practices would be affected as a result of Health Insurance Portability and Accountabilty Act (HIPAA) enactment.

METHODS

A survey was distributed electronically to coordinators and/or directors of level 1 trauma centers. Centers were queried on demographics, trauma video use, and reasons for changes, if any, in their video practice patterns. Descriptive statistics and chi-square analysis were employed.

RESULTS

Survey response rate was 75%. Prior to HIPAA, 58% of responding trauma centers used video compared to 18% now. On a Likert scale of 1-5, video analysis rated 3.80. For those using video currently, the most common purposes are education (91%) and quality assurance (83%). HIPAA has affected the way video is used at one third of these centers. Ten percent receive institutional review board approval for videotaping, 35% get patient consent, and more than half report capturing a poor patient outcome on tape. The most commonly cited reasons for stopping video use were HIPAA and legal concerns about patient privacy, consent, and discoverability (79%). Scarce resources were, in part, to blame at 70% of centers, while video technology was found to be ineffective at only 32%.

CONCLUSIONS

A minority of level I trauma centers currently use video, although it is effective according to users. HIPAA and medicolegal concerns have affected its use at some centers and contributed to its abandonment at others.

Advanced surgical trauma care training with a live porcine model

OBJECTIVE

To evaluate the benefit of a compulsory operative trauma care course for general surgeons in Norway utilising a live porcine model.

METHODS

The participants rated their expertise in 23 situations pre- and post-session on a scale 1-5, where 1 meant "not competent" and 5 meant "fully competent".

RESULTS

Mean total score increased 43% from pre- to post-session. The increase reached significance with all levels of experience. Procedures rarely performed, like suturing on a beating heart, showed a greater educational benefit than more frequently performed procedures, like inserting a chest tube.

CONCLUSION

The operative trauma care animal session increased the participants' perceived competence significantly. Its use seems justified for education in trauma related lifesaving surgical procedures.