Results
Our dry-runs and in-situ simulation identified deficiencies and potential problems such as:
1. Gaps in communication and co-ordination between operating theatre, obstetrics and neonatal teams
2. Consistent breaches in infection prevention: for example:
a. Navigating the patient trolley through narrow corridors with inadvertent contamination of the walls and furniture b. During the donning and doffing processes of PPE c. Missed steps in infection control measures, for example, repeating hand hygiene during the WHO’s 5 moments of hand hygiene.(16)
3. Significant delay of 45 minutes from time of decision to transfer to the designated COVID-19 operating theatre. This was contributed by time to transfer the patient and equipment, compounded by inefficient communication between the various teams.
4. The process of urinary catheterisation before the caesarean was time consuming as it required the assistant to don and doff the PPE multiple times before the start of surgery.
5. Intubation and extubation during general anaesthesia are aerosol generating procedures. All non-anaesthetic members should evacuate the operating theatre to minimise exposure.
To date, there has not been any obstetric case of COVID-19.