COVID-19 drill readies ER staff for the inevitable

Similar test run last fall saved lives after bus crash, doctors say

Media | Watch an Ottawa Hospital simulation drill for a COVID-19 patient with severe symptoms

Caption: Staff at the Ottawa Hospital took part in a simulation drill Friday to practice the intubation and care of COVID-19 patients who develop severe breathing problems. Glen Posner, medical director of the simulation patient safety program, and David Gruber, emergency room physician, spoke to CBC News.

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The Ottawa Hospital has been conducting pandemic drills with its emergency department personnel to prepare them for the special challenges of treating a large wave of sick and infectious patients.
ER doctors, respiratory therapists and nurses worked through a simulation on Friday designed to refine and streamline the safe treatment and transport of a severely ill patient in the midst of respiratory failure.
"The hospital is working really hard to be as prepared as we can be for these patients," said emergency physician George Mastoras.

Image | George Mastoras

Caption: Dr. George Mastoras, an emergency physician, said the exercises can help to reduce stress among doctors and nurses preparing for the real thing. (Stu Mills/CBC)

Mastoras said the "dry run" is meant to ready staff on the front lines of a health-care emergency.
It's the same kind of simulation the hospital credits with saving lives after the Jan. 11 Westboro bus crash.

Image | Corona virus simulation

Caption: In a simulation, an emergency team at The Ottawa Hospital scrambles to stabilize a COVID-19 'patient' in respiratory failure (Stu Mills/CBC)

Earlier simulation saved lives

On Nov. 16, emergency physicians and nurses practised a Code Orange mass casualty emergency at the hospital.
Just two months later, a double-decker OC Transpo bus slammed into a shelter overhang at the Transitway stop, killing three people and badly injuring many more.
"Every patient who was brought to this campus survived," said Dr. Glenn Posner, who oversaw Friday's drill.

Image | disease warning

Caption: The simulation is carried out in a room with negative air pressure. (Stu Mills/CBC)

Friday's patient was a high-tech simulation mannequin capable of blinking, moaning and, if loaded in advance, even sneezing ultrasound gel from its nostrils.

Image | simulation mannequin

Caption: The simulation uses a high-tech mannequin that's even capable of 'sneezing.' (Stu Mills/CBC)

Transporting contagious patients

Friday's training was intended to iron the wrinkles out of the process of having emergency physicians, respiratory therapists and nurses don and doff personal protective equipment, including N95 masks and clear plastic visors.
The hospital has also worked out the complicated process of how to transport contagious and seriously ill patients up to the hospital's intensive care unit.

Image | Dr. Glenn Posner

Caption: Dr. Glenn Posner explains to staff how the simulation will proceed. (Stu Mills/CBC)

To do that, a security team will create a perimeter as the patient is moved down the hallway to a service elevator. Housekeepers will follow, disinfecting the area.
"There's a lot of moving parts in a simulation like that," observed Dr. David Gruber, who led the intubation exercise in a sealed room with negative air pressure.
The aim is to limit the spread of infection, but Gruber said everyone involved is keenly aware of the risks.
"You're always weighing risks and benefits, so naturally you are taking a risk just by leaving the house, by being in the hospital, by taking care of patients, but at the end of the day you have to consider what you are providing for that cost."
Mastoras said no matter how well prepared the hospital may be for the inevitable arrival of critically ill patients, he's hopeful the assessment centre at Brewer Arena that opened Friday will help "deflect" at least some of the volume of patients from the ER.