The Hurst Exponent: A Novel Approach for Assessing Focus During Trauma Resuscitation

Abstract

Current assessment of resuscitation team performance is often based on evaluations using checklists that evaluate verbal communication. However, highly efficient teams may function with several non-verbal cues that may not be measured by current assessment methods. Previous work assessing these non-verbal cues has been accomplished by tracking head movements in providers which however have not been attempted in trauma teams. We sought to perform a preliminary, proof-of-concept study to assess the ability to perform head tracking during a simulated trauma scenario. We enrolled a convenience sample of two simulated trauma teams utilizing undergraduate health professional students from four disciplines available at our institution: 2nd year Radiologic Science (RS), 4th year Physician Assistant (PA), 2nd year Respiratory Care (RT), and 4th year Registered Nurse (RN) students. Each team performed a simulated trauma resuscitation two times while wearing Xsens® MTw motion trackers to track head movements during the resuscitation. These motions were analyzed using a standard measure of discriminating movement patterns known as the Hurst exponent (H). Pre- and post- communication training movement patterns were compared to establish reliability of H in trainees learning trauma resuscitation. There was no difference between the pre- and post- communication training H values for either roll or yaw for any of the four disciplines indicating that non-verbal communications were avoided. The Hurst exponent reliably measures the direction of focus of the participants during some simulated trauma resuscitation scenarios. Future research will be needed to evaluate this analytic technique across providers and in the clinical setting.