Video in the Trauma Room 2
	Date: 24.03.97 15:43 From: Madhu Saxena [MSaxena123@aol.com] I work in a level one trauma center.To improve the performence in a trauma code, we are planning to install a video camers in our trauma room.This will be only for educational purpose for team members ,will not be a part of medical records and will be erased after viewing.I would like to know if in your knowledge there are video camers in EDs ? Is there any legal issue like patient's confidentiality (even though it will not be a part of medical records, and will be purely for teaching purpose for residents.) and how to overcome this obstacle?I will appreciate your experience or infrmation regarding this.
	Date: 25.03.97 02:30 From: Maggi Gunnels [gunnelsm@ohsu.edu] Dr. Saxena - Parkland Hospital Emergency/Trauma Services in Dallas, Texas has policies in place re/ED videotaping that may answer your questions ( I was previously a manager there). (214)590-8735. Maggi Gunnels,OHSU Trauma Program, Portland, Oregon
	Date: 25.03.97 02:43 From: "John A. Aucar, M.D." [jaucar@bcm.tmc.edu] Videos made as part of a structured internal review process for quality improvement are protected from discoverability for civil proceedings by the same privilege that protects written QA documents. They are not protected from subpena as evidence in criminal proceedings. There may be ethical concerns about releasing tapes which may violate physician-patient confidentiality. Suppose for instance that a patient confesses to a crime in your emergency room, should that be reported or released? Some potential strategy include random taping and early erasure. There is probably no sure way to avoid a headache, but I still think that the process is valuable. JAA -- John A. Aucar, M.D.,F.A.C.S. Dept. of Surgery One Baylor Plaza Houston, TX 77030 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Assistant Professor, Surgery, Baylor College of Medicine Ben Taub Gen. Hospital; http://www.bcm.tmc.edu/surgery/ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
	Date: 25.03.97 14:53 From: "Smith, J. Stanley, MD" [JStanley.Smith@hmc.psu.edu] Police can confiscate tapes of resuscitations of suspected criminals. Does not apply to confidentiality laws, but can be gotten with search warrant.
	Date: 26.03.97 22:24 From: kortbeek@supernet.ab.ca (John B. Kortbeek) W.r.t. video cameras in the trauma room. I am currently a trauma surgeon and medical director at a tertiary referral trauma facility. Some years ago as a trauma fellow at a major state trauma center I was given the task of reviewing the videos for quality improvement. The job was not very rewarding, it was a laborious method of assessing the resuscitation process. In my view simple parameters (trauma team response times, time in the emergency bay, time to OR/ICU or CT/Angio, missed injuries, and notations of difficult airway/IV access) are easy to record and provide a more efficient means of assessing trauma team performance. The most rewarding moment in reviewing the tapes was a spontaneous demonstration during a particularly uneventful trauma resuscitation when the residents gathered in front of the camera and delivered a soliloquy, singing the praises of trauma care, affirming their unending devotion to the care of gunshot wounds and their particular affinity for the current trauma fellow. John B. Kortbeek
	Date: 30.03.97 01:57 From: Peter Meade MD [PMCANDO@aol.com] In my institution, videotaped trauma resusitations have been used as political weapons of physicians vs physicians, and the Emergency Medicine Department vs the Surgery Department... and they were stopped when the co-axial cable was cut by secret order of the Chief of Surgery... Much fighting and ill-will have been generated by the use of these "educational" devices. Nope... Video Cameras in the ED are not a very good idea. Peter Meade, MD SICU Director King/Drew Medical Center Los Angeles
	Date: 30.03.97 18:17 From: "Roy L. Alson, PhD, MD" [ralson@bgsm.edu] We have been using video tapes of trauma resuscitations for years, as a QI tool. The tapes are reviewed regularly by ED and Trauma staff and then erased. They are seen only be members of the services, involved in the care of trauma patients. This is analagous to performing chart reviews for QI and one should take the same safeguards for protection of patient confidentiality for the tapes, that one does for chart reviews. We also include in our QI protocol a discussion of how tapes are used and how they are handled. Hope this helps. Regards, Roy ++++++++++++++++++++++++++++++++++++++++++ Roy L. Alson, PhD, MD, FACEP Assistant Professor of Emergency Medicine Bowman Gray School of Medicine Medical Director-EMS NC Baptist AirCare
	Date: 02.04.97 22:47 From: Yasser Mohsen [yassermohsen@compuserve.com] It appears ED goings on are becoming more and more theatrical. ED workers require an increasing audience to be able to do what has always been done without melodrama, fanfare or applause. Not surprised that Video Cameras have generated much fighting and ill-will in your hospital. The gap between regimented protocols followed in ED and gut feelings of surgeons is difficult to bridge. When ED departments chiefs stop imagining that the rest of the hospital is at their beck and call just so as they can swell the number of spectators at trauma calls, as happens in this country, then maybe these "educational" devices will not generate ill feelings.
	Date: 03.04.97 15:45 From: Glen Hawkins [glenhawk@ozemail.com.au] No I think the politics were more at fault here. The video is a useful teaching tool and QI if people are willing to swallow their own ego and accept constructive criticism....a trait which is sadly lacking in our profession these days. Cheers Glen Glen Hawkins (glenhawk@ozemail.com.au)