Benjamin K. Kogutt, MD, is a Clinical Fellow, Department of Gynecology and Obstetrics, Division of Maternal-Fetal Medicine, Johns Hopkins Hospital, Johns Hopkins University School of Medicine, Baltimore, MD.
Jeanne S. Sheffield, MD, is Division Director, Department of Gynecology and Obstetrics, Division of Maternal-Fetal Medicine, Johns Hopkins Hospital, Johns Hopkins University School of Medicine, Baltimore, MD.
Health Secur. 2019 Jan/Feb;17(1):18-26. doi: 10.1089/hs.2018.0090.
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.
这篇文章描述了一个大规模的场景，旨在测试美国生物隔离单位管理一名感染高后果病原体的孕妇的能力，并在分娩和自然阴道分娩后照顾新生儿。我们创建并执行了一项具有模拟功能的多学科功能演习，以测试约翰霍普金斯医院生物隔离单位（BCU）管理一名患有未知呼吸道疾病的临产孕妇并为其分娩和稳定新生儿的能力。BCU 演习和演练委员会根据国土安全和演练计划指南，与约翰霍普金斯模拟中心合作制定了演练目标并执行了演练。通过事后报告和客观测量来评估演练目标，以检测污染情况，并使用荧光标记模拟在典型分娩场景中会遇到的生物危害液体。演练的直接目标是完成母亲的稳定以及新生儿的成功分娩和复苏。在演练结束时，用紫外线检查演练参与者时，没有发现污染的证据。模拟优化了团队合作、沟通和安全性，这些对于感染或有感染高后果病原体风险的孕产妇单位的多学科护理至关重要。从这次演练中吸取的关于患者转运、安全性以及产科和新生儿注意事项的经验教训，将为未来的演练和协议提供信息，并帮助其他中心为在隔离条件下照顾孕妇做好准备。
