Authors (including presenting author) :
Hui CYT(1), Leung SMA(1)
Affiliation :
(1)Department of Anaesthesia, PYNEH, HKEC
Introduction :
COVID-19 is a respiratory illness caused by coronavirus SARS-CoV-2. The pandemic emerged in early 2019 and is still affecting us. The virus causes severe pneumonia which may lead to respiratory failure, urges the need for mechanical ventilation. Intubation is an aerosol generating procedure which carries a high risk of spreading the viruses to the personnel and environment, it was believed that the risk of contamination can be reduced with better planning and executed by airway experts with appropriate equipment. Thus we anticipated increased requests for intubation by anaesthetists outside operating theatre during COVID-19 pandemic. Our department of Anaesthesia tried to standardize our intubation practices to improve efficiency and safety. We also designed and prepared a prepacked intubation bag facilitating the intubation for reducing contamination to the surroundings.
Objectives :
The primary objective of the COVID-19 airway drill was to allow the staff in Anaesthesia to practice the infection control measures for intubation outside operating theatre to minimize aerosol generation and risk of transmission, with the prepacked intubation bag.
Methodology :
Three-full-day simulation training program with 26 identical sessions was conducted in PYNEH and RH from February to March 2020. A total of 46 staff involved in usual intubation calls including 26 anaesthetists and 20 OTAs joined the program. Nurses were invited to be observers. The simulation scenarios required the participants to intubate a deteriorating patient with suspected COVID-19 in the isolation ward. All participants were assessed individually on their performance in planning and executing intubation procedure as well as proper donning and doffing of PPE. Debriefing was given after each simulation. The participants were taught on the assembly of the specific enclosed breathing circuit as well. The list of items in the pre-packed bag for intubation was introduced to our staff during this exercise. Staff with suboptimal performance during simulation were asked to repeat the training.
Result & Outcome :
Our intubation drill simulation program achieved a participation rate of 90% of our target participants. Two anaesthetists and 1 OTA were unable to join as they were on leave during that period. All participants found the simulation useful in equipping them with the skills and experience in attending intubation calls for suspected or confirmed COVID-19 patients. We also further revised the contents of the pre-packed intubation pack after feedback from staff during our simulation drill so to ensure the efficiency and safety of our staff.
