The Preparation, Delivery and Outcome of COVID-19 Pandemic Training Program among the Emergency Healthcare Frontliners (EHFs): The Malaysian Teaching Hospital Experience

EHFs Training in COVID-19
Vol. 15 No. 1 : 2020 (250-265)

Mohd Hisham I Mohd Hisham I
AZLAN HELMY AS AZLAN HELMY AS
Ismail MS Ismail MS

Abstract
One of the strategies in strengthening the healthcare providers in mitigating the impact of COVID-19 pandemic is through training. Safety and disease unfamiliarity with COVID-19 was the main reason for developing this dedicated specialized training modules in order to address the issue. The training modules were developed based on three strategies that are learning from experience, design suitable dedicated module and identify weakness and vulnerability. The training modules created were  donning-doffing of Personal Protective Equipment (PPE), airway management and cardiopulmonary resuscitation of suspected COVID-19 patients which were delivered through immersive life simulation technique. A total of 178 Emergency Healthcare Frontliners (EHFs) were trained. Each module was guided with a checklist that the participants found to be very useful. None of the participants reported developing symptoms of infection after undergoing the face-to-face simulation training even after two weeks of post-training periods. Seven important steps were found to be crucial that contributed to these findings which included room space, participants number per group, COVID-19 screening, taking of temperature, hand sanitization, PPE, and equipment sanitization before and after training. Hands-on training with guided-checklist  was found to be very useful to the EHFs in managing an unfamiliar situation of COVID-19. In time-constraint-resource-limited conditions, training modules should be focused  on addressing the pressing problem at hand. In conducting  a face-to-face training, precautionary safety measures should be strictly adhered  to prevent the spread of the disease. 

Keywords : Airway, cardiopulmonary resuscitation, COVID-19, safety, training,

Correspondance Address
Dr Ismail Mohd Saiboon. Department of Emergency Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia. Tel: +603-9145 5491 Email: fadzmail69@yahoo.com.my/ ismail@ppukm.ukm.edu.my


References
Academy of Emergency Sciences Manila. 2020. Aha Covid 19 Pals Algorithm. https://www.facebook.com/aesciencesmanila/posts/covid-blue-cpr-in-the-time-of-covid-19-last-edited-april-10-2020-whats-new1-adde/839713119771071/) [10 May 2020]. Brewster, D.J., Chrimes, N.C., Do, T.B., Fraser, K., Groombridge, C.J., Higgs, A., Humar, M.J., Leeuwenburg, T.J., Mcgloughlin, S. Newman, F.G. 2020. Consensus Statement: Safe Airway Society Principles of Airway Management and Tracheal Intubation Specific to the Covid-19 Adult Patient Group. Med J Aust 16. Cook, T., El-Boghdadly, K., Mcguire, B., Mcnarry, A., Patel, A., Higgs, A. 2020. Consensus Guidelines for Managing the Airway in Patients with Covid-19: Guidelines from the Difficult Airway Society, the Association of Anaesthetists the Intensive Care Society, the Faculty of Intensive Care Medicine and the Royal College of Anaesthetists. Anaesthesia. Driggin, E., Madhavan, M.V., Bikdeli, B., Chuich, T., Laracy, J., Bondi-Zoccai, G., Brown, T. S., Der Nigoghossian, C., Zidar, D.A., Haythe, J. 2020. Cardiovascular Considerations for Patients, Health Care Workers, and Health Systems During the Coronavirus Disease 2019 (Covid-19) Pandemic. J Am Coll Cardiol 75(18): 2352-71. Edelson, D.P., Sasson, C., Chan, P.S., Atkins, D.L., Aziz, K., Becker, L.B., Berg, R.A., Bradley, S.M., Brooks, S.C., Cheng, A. 2020. Interim Guidance for Basic and Advanced Life Support in Adults, Children, and Neonates with Suspected or Confirmed Covid-19: From the Emergency Cardiovascular Care Committee and Get with the Guidelines®-Resuscitation Adult and Pediatric Task Forces of the American Heart Association in Collaboration with the American Academy of Pediatrics, American Association for Respiratory Care, American College of Emergency Physicians, the Society of Critical Care Anesthesiologists, and American Society of Anesthesiologists: Supporting Organizations: American Association of Critical Care Nurses and National Ems Physicians. Circulation 141(25) Fried, J.A., Ramasubbu, K., Bhatt, R., Topkara, V.K., Clerkin, K.J., Horn, E., Rabbani, L., Brodie, D., Jain, S.S., Kirtane, A. 2020. The Variety of Cardiovascular Presentations of Covid-19. Circulation. http://danielburkhoff.com/papers/pdf/DB-Reference-356.pdf [2nd May 2020] Ibrahim, M.I., Parzi, M.N., Muzamir, M.Y., Sulaiman., N. A. 2020. 325 Petugas Kkm Positif Covid-19. Berita Harian Online, [23 April 2020] Jhaveri, R. 2020. Echoes of 2009 Pandemic H1n1 Influenza with the Covid Pandemic. Clinical Therapeutics 42(5): 736-40. Kantor, J. 2020. Behavioral considerations and impact on personal protective equipment (PPE) use: early lessons from the coronavirus (Covid-19) outbreak. J Am Acad Dermatol 82(5): 1087-8. Lai, C.C., Shih, T.P., Ko, W.C., Tang, H.J., Hsueh, P.R. 2020. Severe Acute Respiratory Syndrome Coronavirus 2 (Sars-Cov-2) and Corona Virus Disease-2019 (Covid-19): The Epidemic and the Challenges. Int J Antimicrob Agents 55(3): 105924. Ministry of Health Malaysia. 2020. Statistik Terkini Covid-19 Di Malaysia Setakat Jam 5:00 Petang Yang Dikeluarkan Oleh Kkm (29 April). https://www.moh.gov.my/index.php/pages/view/2019-ncov-wuhan [1st May 2020]. Moore, D., Gamage, B., Bryce, E., Copes, R., Yassi, A., Group, B.I.R.P.S. 2005. Protecting health care workers from sars and other respiratory pathogens: organizational and individual factors that affect adherence to infection control guidelines. Am J Infect Control 33(2): 88-96. Peeri, N.C., Shrestha, N., Rahman, M.S., Zaki, R., Tan, Z., Bibi, S., Baghbanzadeh, M., Aghamohammadi, N., Zhang, W., Haque, U. 2020. The Sars, Mers and Novel Coronavirus (Covid-19) Epidemics, the Newest and Biggest Global Health Threats: What Lessons Have We Learned? Int J Epidemiol :1-10. Public Health England. 2020. High Consequence Infectious Diseases (Hcid). https://www.gov.uk/guidance/high-consequence-infectious-diseases-hcid [2nd May 2020] Rimmer, A. 2020. Covid-19: Two Thirds of Healthcare Workers Who Have Died Were from Ethnic Minorities. BMJ 369: 1621. Saiboon, I.M., Apoo, F.N., Jamal, S.M., Bakar, A.A., Yatim, F.M., Jaafar, J.M., Berg, B.W. 2019. Improving the position of resuscitation team leader with simulation (imports); a pilot cross-sectional randomized intervention study. Medicine 98(49): e18201. Wang, J., Zhou, M., Liu, F. 2020. Exploring the Reasons for Healthcare Workers Infected with Novel Coronavirus Disease 2019 (Covid-19) in China. J Hosp Infect 105(2020): 100-1. Wilder-Smith, A., Chiew, C.J., Lee, V.J. 2020. Can We Contain the Covid-19 Outbreak with the Same Measures as for Sars? Lancet Infect Dis 20(5): e102-107. World Health Organisation. 21st May 2020. Coronavirus Disease (Covid-2019) Situation Reports-122. https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports [22nd May 2020]. World Health Organisation. 2020. Coronavirus Disease (Covid-19) Advice for the Public. https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public [10th April 2020]. World Health Organisation. March, 2020. Coronavirus Disease (Covid-2019) Situation Reports : 69. https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200329-sitrep-69-covid-19.pdf?sfvrsn=8d6620fa_2 [10th April 2020]. Xiang, Y.T., Jin, Y., Wang, Y., Zhang, Q., Zhang, L., Cheung, T. 2020. Tribute to Health Workers in China: A Group of Respectable Population During the Outbreak of the Covid-19. Int J Biol Sci 16(10): 1739-40.