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Simulation to Train Pediatric ICU Teams in Endotracheal Intubation of Patients with COVID-19

Shilpa C Balikai1, Aditya Badheka1, Andrea Casey2

  • 1Division of Pediatric Critical Care, Department of Pediatrics, University of Iowa Carver College of Medicine, Iowa City, Iowa; and.

Pediatric Quality & Safety
|January 6, 2021
PubMed

Insights

A simulation program rapidly improved pediatric intensive care unit (PICU) teams' ability and confidence in performing endotracheal intubations during the COVID-19 pandemic.

Area of Science:

  • Pediatric critical care medicine
  • Infectious disease control
  • Medical simulation and education

Background:

  • Healthcare workers require protection from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission.
  • Workflow modifications in pediatric intensive care units (PICUs) are essential for infection control.

Purpose of the Study:

  • To rapidly train interdisciplinary PICU teams to safely perform endotracheal intubations in pediatric patients with suspected or confirmed COVID-19.
  • To enhance the safety of healthcare workers during aerosol-generating procedures.

Main Methods:

  • A quality improvement study was conducted in a tertiary referral PICU.
  • Stakeholder-driven guidelines for modified intubation were developed.
  • A structured simulation program trained physicians, nurses, and respiratory therapists.
  • Adherence to modified intubation processes and staff confidence were assessed before and after simulation.

Main Results:

  • Fifty PICU staff participated in 9 simulation sessions.
  • Observed intubation performance improved, with teams executing more recommended practices (P = 0.024).
  • Staff confidence significantly increased from a mean SET-M score of 0.9 to 2 (P < 0.001).

Conclusions:

  • A rapidly deployed, structured simulation education program effectively improved PICU teams' performance and confidence.
  • Safe execution of modified endotracheal intubation for pediatric COVID-19 patients was enhanced.
  • Simulation is a valuable tool for improving healthcare worker preparedness during public health crises.

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