Ok, some of the learning points we found in our ICU in-situ #covidsim today.
@ICS_updates @DrSarahMarsh @EM3FOAMed @NWCriticalCare @wjp76 @FICMNews @HarrogateNHSFT @HarrogateICU @Martintastic @ICU_Reading @RBH_ICU_Physio
@ICS_updates @DrSarahMarsh @EM3FOAMed @NWCriticalCare @wjp76 @FICMNews @HarrogateNHSFT @HarrogateICU @Martintastic @ICU_Reading @RBH_ICU_Physio
1] Aids to have available;
PPE donning/doffing
assets.publishing.service.gov.uk/government/upl…
'Outside room' checklist
@Gas_Craic @Wilkinsonjonny
available at criticalcarenorthampton.com/2020/03/08/cov…
PPE donning/doffing
assets.publishing.service.gov.uk/government/upl…
'Outside room' checklist
@Gas_Craic @Wilkinsonjonny
available at criticalcarenorthampton.com/2020/03/08/cov…
We used our standard intubation checklist in the room, but covid19 ones are available too. Main difference being advice on trying to avoid bag valve ventilation which we verbalised. Checklist normally attached to airway trolley - need loose disposable paper copies!
2] Careful preparation before entering room key - relevant airway kit removed from airway trolley and placed on metal trolley to take in room. CMAC VL with standard and D disposable blades for ease of cleaning. Some evidence to support use of VL. All likely needed drugs prepared.
3] Buddy supervision of donning prior to room entry.
4] Airway trolley placed outside the room
5] Runner to remain outside room until procedure complete and patient stable
6] People in room reduced to minimum safe numbers
4] Airway trolley placed outside the room
5] Runner to remain outside room until procedure complete and patient stable
6] People in room reduced to minimum safe numbers
7] PPE made life difficult - with visor can't visualise people well due to glare and difficult to look out of, excessive misting in short space of time, difficult to communicate with mask and visor.
8] Unable to visualise name badges through gown - likely to be working with staff from theatres/wards who we don't know well - suggest stickers on a roll and put names on prior to entering.
9] Manikin proned - accidental circuit disconnection - all staff were in full PPE already
9] Manikin proned - accidental circuit disconnection - all staff were in full PPE already
10] We have no negative pressure rooms with ante rooms - problems with doffing. Supervised doffing in room of gloves, gown and visor. Mask removed outside room but no yellow bin or immediately available hand washing facilities outside room.
11] useful to have supply of the blue plastic scissor clamps readily handy for clamping ETT when changing from Water's circuit to ventilator etc.
12] Team unsure of whether meant to be using ventilator with or without humidification.
12] Team unsure of whether meant to be using ventilator with or without humidification.
13] Found the outside room checklist really useful for focusing preparation and minimising room entry/exit.
14] Running scenario again tomorrow a few times with learning from today and likely more tweaks needed!
14] Running scenario again tomorrow a few times with learning from today and likely more tweaks needed!
More tweaks to follow after further sim today.
