Thread on learning points from our Cat1 CS #COVID19_Sim @OUHospitals today. Phenomenal engagement from across so many departments: Anaesthetics, Obstetrics, Neonatology, Midwifery, Threatre, Scrub, Infection Control, Portering, Domestics & @OxSTaRCentre. This was crucial 💫 
#PPI We had an actor for the first part of the simulation. This allowed us to capture the woman’s perspective. Cat 1 CS is stressful- as reported by our actor. The Obs & MW team were amazing at continuously communicating and reassuring where appropriate despite muffled mask.
#PPE: it needs repeated practice. 1) Be aware of opening doors and contaminating two sides of the door -it is very easy. 2) Try not to wipe your nose/face on your shoulder. 3) How to make donning efficient?(reciprocal buddy?)
#Transfer: #olddoors in our corridors 1) person allocated to clear corridors of people & equipment. Then props doors open (then unprops them ASAP- to reduce fire hazard risk). 2) #Notouchtransfer A porter guides the transfer to theatre to minimize corridor contamination
#Designatetheatre: 1)aim to designate a theatre as COVID-19 once a laboring +ve women is admitted 2) remove all unnecessary equipment before case (computers, trolleys) to minimize contamination and cleaning workload after- the scrub team worked hard on this before our scenario.
#Intheatre 1)minimize the # of people in theatre. 2) with Neonatology we decided it was safest to take the baby out of theatre ASAP for assessment and care 3) it’s hard to identify people so write your #nameonvisor 4) minimize background noise 5)speak slowly, speak loudly
#teamwork: 1) The #WHOchecklist works. 2) all staff need full PPE because of proximity to intubation area in a Cat 1 CS 3) runners outside theatre can pass equipment & drugs without getting contaminated BUT they find it v hard to hear the requests. 4)remember the woman!
What is clear is that this situation will require more staff (which will be the true challenge as this pandemic evolves). But if we keep sharing our #COVID19_Sim & take care of each other hopefully we will be able to do the best for our patients and each other. Thank u 4 reading
