Simulation of a spontaneous vaginal delivery and neonatal resuscitation in a biocontainment unit

Benjamin K. Kogutt, Jeanne Sheffield, Dianne Whyne, Lisa Maragakis, Jennifer Andonian, Jade Flinn, Chris Sulmonte, Adam Dodson, Mark Romig, Lauren Sauer, Robert Maloney, Janis Ferrell, Arthur Vaught, W Christopher Golden, Brian Thomas Garibaldi

Research output: Contribution to journalArticle

Abstract

This article describes a large-scale scenario designed to test the capabilities of a US biocontainment unit to manage a pregnant woman infected with a high-consequence pathogen, and to care for a newborn following labor and spontaneous vaginal delivery. We created and executed a multidisciplinary functional exercise with simulation to test the ability of the Johns Hopkins Hospital biocontainment unit (BCU) to manage a pregnant patient in labor with an unknown respiratory illness and to deliver and stabilize her neonate. The BCU Exercise and Drill Committee established drill objectives and executed the exercise in partnership with the Johns Hopkins Simulation Center in accordance with Homeland Security and Exercise Program guidelines. Exercise objectives were assessed by after-action reporting and objective measurements to detect contamination, using a fluorescent marker to simulate biohazardous fluids that would be encountered in a typical labor scenario. The immediate objectives of the drill were accomplished, with stabilization of the mother and successful delivery and resuscitation of her newborn. There was no evidence of contamination when drill participants were inspected under ultraviolet light at the end of the exercise. Simulation optimizes teamwork, communication, and safety, which are integral to the multidisciplinary care of the maternal-fetal unit infected, or at risk of infection, with a high-consequence pathogen. Lessons learned from this drill regarding patient transportation, safety, and obstetric and neonatal considerations will inform future exercises and protocols and will assist other centers in preparing to care for pregnant patients under containment conditions.

Original languageEnglish (US)
Pages (from-to)18-26
Number of pages9
JournalHealth Security
Volume17
Issue number1
DOIs
StatePublished - Jan 1 2019

Fingerprint

Resuscitation
Mandrillus
labor
Exercise
environmental pollution
simulation
transportation safety
pathogen
scenario
Personnel
Pathogens
neonate
obstetrics
teamwork
containment
Homelands
stabilization
Contamination
Newborn Infant
Obstetrics

Keywords

  • Biocontainment unit
  • Neonatal resuscitation
  • Simulation
  • Spontaneous vaginal delivery

ASJC Scopus subject areas

  • Health(social science)
  • Emergency Medicine
  • Safety Research
  • Public Health, Environmental and Occupational Health
  • Management, Monitoring, Policy and Law
  • Health, Toxicology and Mutagenesis

Cite this

Simulation of a spontaneous vaginal delivery and neonatal resuscitation in a biocontainment unit. / Kogutt, Benjamin K.; Sheffield, Jeanne; Whyne, Dianne; Maragakis, Lisa; Andonian, Jennifer; Flinn, Jade; Sulmonte, Chris; Dodson, Adam; Romig, Mark; Sauer, Lauren; Maloney, Robert; Ferrell, Janis; Vaught, Arthur; Golden, W Christopher; Garibaldi, Brian Thomas.

In: Health Security, Vol. 17, No. 1, 01.01.2019, p. 18-26.

Research output: Contribution to journalArticle

Kogutt, Benjamin K. ; Sheffield, Jeanne ; Whyne, Dianne ; Maragakis, Lisa ; Andonian, Jennifer ; Flinn, Jade ; Sulmonte, Chris ; Dodson, Adam ; Romig, Mark ; Sauer, Lauren ; Maloney, Robert ; Ferrell, Janis ; Vaught, Arthur ; Golden, W Christopher ; Garibaldi, Brian Thomas. / Simulation of a spontaneous vaginal delivery and neonatal resuscitation in a biocontainment unit. In: Health Security. 2019 ; Vol. 17, No. 1. pp. 18-26.
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