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BackgroundThe COVID-19 pandemic resulted in significant numbers of patients requiring intubation and transfer To achieve this ‘Mobile Emergency Rapid Intubation Teams’ (MERIT) were created Mindful of individuals working outside of their normal environment, we created a simulation training program to improve clinical care and ensure staff and patient safety Education ProgrammeThe MERIT call process was simulated in high-fidelity including team brief, preparing equipment, use of personal protective equipment, induction and intubation An educational video was created for viewing prior to simulation events Debriefs were conducted after every simulation and MERIT call;multiple issues were raised which facilitated regular guidance updates Faculty ran daily simulations for five weeks ResultsPost-training evaluation:•Thirty-nine participants responded•95% attended at least one training session•82% felt that training significantly improved their understanding of MERIT processes•84% and 87% strongly agreed that the training improved teamwork and safety respectively•82% strongly agreed that the training improved standardisation•77% strongly agreed that training left them well-prepared to undertake MERIT calls•Thematic analysis of participant’s reflections showed the following domains were most valuable: practicing processes, correct use of equipment and task management Patient outcome data:•23 live MERIT calls between 25th March and 5th May 2020•Average time from arrival to intubation was 26min (range 13–36min)•Average time from arrival to departure was 43min (range 27–75min)•Choice of anaesthetic agents was identical in all intubations•3 episodes of desaturation (SpO2 <80%) and 2 episodes of hypotension (Systolic BP <90mmHg)•No other critical incidents reportedDiscussionThe rapid introduction of MERIT necessitated a training programme that simultaneously trained staff and developed processes 1 Intubation of COVID-19 patients exposes clinicians to significant personal risk and this programme sought to mitigate risks by standardising procedures and reinforcing best practice Feedback suggests that the programme improved teamwork, safety, and confidence of staff caring for critically unwell individuals Patient outcome data showed intubations were timely and with minimal physiological derangement This reinforces previous evidence that standardisation can improve outcomes 2ConclusionsIn this programme, translational simulation facilitated training of a large number of clinicians to perform the complex, novel and evolving role of MERIT in a short timeframe Keeping staff safe was an important positive theme to emerge from the participant survey RecommendationsTargeted ‘diagnostic’ translation simulation should be considered when introducing a novel service to facilitate rapid learning and development of new models of care ReferencesBrazil, V Translational simulation: not ‘where?’ but ‘why?’ A functional view of in situ simulation Advances in Simulation volume 2, Article number: 20 (2017) https://advancesinsimulation biomedcentral com/articles/10 1186/s41077-017-0052-3 (Accessed 18/05/20)McQueen C, et al Prehospital anaesthesia performed by physician/critical care paramedic teams in a major trauma network in the UK: a 12 month review of practice Emerg Med J 2015 Jan;32(1):65-9 https://www ncbi nlm nih gov/pubmed/24132327 (Accessed 18/05/20)
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