Developing a simulation programme to train airway management during the COVID-19 pandemic in a tertiary-level hospital

Abstract

Tracheal intubation of a patient with COVID-19 is a high-risk procedure for not only the patient, but all healthcare workers involved, leading to an understandable degree of staff anxiety. We used simulation to help train airway managers to intubate patients with COVID-19. Based on action cards developed by our department, we designed a series of scenarios to simulate airway management during the COVID-19 pandemic. Teams were asked to perform a rapid sequence induction with tracheal intubation. We designed in situ scenarios with low-fidelity manikins that could be set up in operating theatres across multiple sites. Over a period of 4 weeks, 101 consultant anaesthetists, 58 anaesthetic trainees and 30 operating department practitioners received intubation training. These members made up the airway response team of our hospital. 30 emergency department doctors also received training in anticipation of further COVID-19 surges leading to the possibility of overwhelmed services. Simulation-based training was an invaluable tool for our hospital to rapidly upskill medical professionals during the first wave of the COVID-19 pandemic. We have used feedback and additional guidelines to improve our scenarios to retrain staff during subsequent waves.

Retailoring training programmes in anaesthesia and intensive care after the coronavirus disease 2019 outbreak

“…Although learning opportunities in airway management have changed dramatically during the pandemic, many aspects of airway instrumentation, could improve with the increase in simulation and theoretical training [24]. Simulation and training courses [25], including live audio-visual lectures, case scenarios, skill demonstrations and mannequin-based video clips on the sequence of airway equipment, drug preparation, airway examination and airway management plans, emerge as an alternative solution for training during the pandemic [26].…”

Articulating Video Stylet Compared to Other Techniques for Endotracheal Intubation in Normal Airways: A Simulation Study in Consultants with No Prior Experience

“…In this regard, the use of simulation provides great opportunities to improve confidence and familiarity with airway management techniques (ETI, but also bag-mask ventilation and the placement of supraglottic airway devices), especially under difficult situations and for novices [3,4]; moreover, simulation offers the chance to gain experience with new equipment and devices [5]. Recently, in the context of the pandemic, simulation has also allowed for familiarization with procedures performed under the constraints of wearing personal protective equipment [6].…”