COVID-19 Obstetric Preparedness

Overview

Learning Objectives

By practicing this scenario, members of an interdisciplinary care team should be able to do the following:

• Recognize risk factors for infection with COVID-19
• Demonstrate appropriate triage, isolation and describe PPE use for patients with suspected COVID19 infection
• Explain how to transport patient to appropriate location or room by specified route to decrease risk of exposure to other patients/healthcare professionals
• Provide correct contact information for supervisor, infection control staff, or both as directed by institutional policy
• Describe current policy recommendations with regards to patient evaluation and COVID-19 testing

Simulation Description

The current COVID-19 pandemic presents challenges to the medical community on a scale not seen previously in our lifetime. Even though there is much we do not know about the virus, the CDC has classified pregnant patients as a group that may be at increased risk. (1) Additionally, patients presenting in labor or with complications of the disease may require delivery, which presents additional logistical and infection control issues.

In order to prepare for patients who present during pregnancy, we are providing these simulation exercises as a way for institutions of all sizes to help design and/or practice their local protocols for management of obstetric patients who present with suspected for confirmed COVID-19 infections.

These are meant to be conducted to walk through institution plans for how to triage, transport and manage obstetric patients by reviewing each step of the process from the time they present and then addressing any gaps identified. It will also improve team preparedness and improve the care team’s confidence in their ability to handle this new and unfamiliar situation.

With each simulation, there is a global checklist that addresses the key areas for patient care and infection prevention. Of note, because of the significant potential for shortages of personal protective equipment (PPE), when running the simulations it is recommended that the team place a “mask”* on the simulated “patient” but all other physician or health care professional PPE and donning/doffing procedures be discussed rather than actually done in order to maintain supplies for real cases.

Realize that information and recommendations will continue to change as more is understood about the virus. In line with this, although we intend to revise as recommendations are modified, please continue to check with the ACOG and CDC websites for updates.

*For the purposes of simulation and due to limited PPE resources, use a substitute such as a bandana or cloth in lieu of a mask on the simulated patient.