In January of 2020, the University Health Network (UHN) Emergency Department in collaboration with the Michener Institute of Education started running in-situ simulations addressing team preparedness for the coronavirus (2019-nCoV) outbreak.
Participants include staff Physicians, Nurses, Respiratory Therapists, and Practitioners from Infection Prevention and Control (IPAC).
The SARS outbreak of 2003 was a catalyst for the simulation designers to represent a simulation that provided a sense of the danger and intensity of a first contact with a person presenting with the coronavirus. The spread of the virus from person to person is mainly through respiratory droplets, so I wanted my manikin to produce an actual wet sneeze or cough. To further enhance the simulation, “Glo Germ”, was incorporated which is a product that comes in a transferable cream or powder and glows under an ultraviolet light source.
I developed a system to aerosolize fluid using Bernoulli’s Principle and was incorporated that into the manikin’s nostril. The Glo Germ was spread on the manikin’s face, hands and clothing, and on the handrails of his stretcher.
When the simulation begins, it feels like the participants are excited and nervous, but it is low-key. In the isolation room the “danger” becomes more real and the simulation more intense when the sick patient produces a series of wet sneezes, whether its into the atmosphere, O2 facemask, or onto the staff. The learning is immediate. I’ve noticed people pause to quickly re-evaluate their PPE and safety, and another verbalize “oh sh*t I forgot my face shield.”
The simulation is ongoing with other groups of front line health professionals.