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.