Multi-Disciplinary Simulation Training for Surgical Tracheostomy in Patients Mechanically Ventilated Secondary to Severe Acute Respiratory Syndrome Coronavirus-2

Abstract

Objective: A proportion of COVID-19 patients with severe respiratory manifestations of disease will require admission to intensive care for intubation and ventilation. When anticipating prolonged ventilation, the patient may proceed to surgical tracheostomy to afford safe respiratory wean. As surgical tracheostomy is an aerosol-generating procedure, it poses a high risk of viral transmission and ultimately may prompt anxiety and caution in participating staff members. We aimed to mitigate these risks by providing staff with appropriate training and experience to improve their confidence as well as practical ability. Methods: We developed a multi-disciplinary simulation training experience and checklist in order to optimize team performance during the high-stakes procedure. We evaluated staff confidence before and after the training with questionnaires. Results: Post-simulation, surgeons were more confident with donning the high-level personal protective equipment, and nurses were more confident in performing their role. Conclusions: Simulation allows the multi-disciplinary team an opportunity to practise high-risk procedures and prompts the team to assess staff knowledge base, troubleshoot queries, and teach roles and responsibilities in a safe environment. In the context of COVID-19, simulation encourages the staff’s sense of preparedness and protection for true participation during a high-risk procedure.