Telesimulation for COVID-19 Ventilator Management Training With Social-Distancing Restrictions During the Coronavirus Pandemic

Background. In early 2020, the novel coronavirus pandemic forced communities around the globe to shut down and isolate. Routine graduate medical education activities have also been suspended as resident and fellow physicians-in-training have been re-deployed to support critical patient care services.Innovation. We developed a two-part hybrid telesimulation model to teach COVID-19 ventilator management strategies while physically separating a group of learners and an instructor from one another. Learners consisted of non-ICU health care providers with limited experience in ventilator management being redeployed to manage ICU level COVID-19 infected patients. In the first week, the video tutorial has been viewed over 500 times and we have facilitated 14 telesimulation sessions, including 48 participants comprised of hospitalists, emergency medicine physicians and physician assistants, pediatric residents, nurses, and a nurse educator.Conclusion. We believe that the combination of a video tutorial followed by an interactive telesimulation was successful in providing timely education during a coronavirus pandemic. Furthermore, it reinforced the value and flexibility in which simulation education could continue conveniently for learners despite significant restrictions in place during the coronavirus pandemic. Research is needed to assess the efficacy of this hybrid intervention in preparing healthcare workers and to determine if the knowledge is successfully transferred to the clinical setting.

Using cloud manufacturing to establish an ecosystem network for COVID-19 ventilator production

Cloud Manufacturing (CMfg) as a service-oriented manufacturing (SOM) paradigm promotes the paradigm of partnership and collaboration among the globally distributed resources. Like technology-based marketplaces, it can identify different suppliers, determine their available services, and assign them to the requested orders based on the service-demand matching mechanism. The dominant capabilities of the SOM as a service can provide a collaborative and flexible manufacturing network configuration. This paper has focused on developing a new CMfg architecture with a concentrating on collaborative concepts to elaborate the modular manufacturing through the virtual process. In this model, different parts of the customized products can be designed as modules produced by distributed suppliers. A (Formula presented.) representation model for the SOM system has been proposed by this architecture. The proposed architecture is enriched by the help of novel technologies presented in Industry 4.0 (I4.0). The model's performance can be evaluated through different approaches, like topology analysis. Furthermore, to simulate a modeling procedure of the architecture, the process of the ventilator production marketplace is discussed in Tehran, Iran. The capabilities of the model analysis to configure the CMfg network and fulfilling the demands have also been described. © 2023 Informa UK Limited, trading as Taylor & Francis Group.

Using cloud manufacturing to establish an ecosystem network for COVID-19 ventilator production

Cloud Manufacturing (CMfg) as a service-oriented manufacturing (SOM) paradigm promotes the paradigm of partnership and collaboration among the globally distributed resources. Like technology-based marketplaces, it can identify different suppliers, determine their available services, and assign them to the requested orders based on the service-demand matching mechanism. The dominant capabilities of the SOM as a service can provide a collaborative and flexible manufacturing network configuration. This paper has focused on developing a new CMfg architecture with a concentrating on collaborative concepts to elaborate the modular manufacturing through the virtual process. In this model, different parts of the customized products can be designed as modules produced by distributed suppliers. A $${\rm{Matchin}}{{\rm{g}}_{{\rm{Net}}}}$$MatchingNet representation model for the SOM system has been proposed by this architecture. The proposed architecture is enriched by the help of novel technologies presented in Industry 4.0 (I4.0). The model's performance can be evaluated through different approaches, like topology analysis. Furthermore, to simulate a modeling procedure of the architecture, the process of the ventilator production marketplace is discussed in Tehran, Iran. The capabilities of the model analysis to configure the CMfg network and fulfilling the demands have also been described.

A junior doctor's experience of critical illness: from treating patients to becoming a patient with COVID-19.

When the coronavirus disease 2019 (COVID-19) pandemic was declared, it was clear that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) would have far-reaching impacts on medicine, society and everyday life. As a junior doctor working closely with patients with SARS-CoV-2 infection, I was aware of my personal risk of exposure to the virus. I assumed that as a fit and well 26-year-old with no comorbidities, if I were to become infected, it was unlikely that COVID-19 would be severe. However, I became critically unwell following a week of clinical work, necessitating hospital admission, tracheal intubation and mechanical ventilation. I remained mechanically ventilated for 6 days and was then transferred to a medical ward 2 days later. After two further days of rehabilitation, I was discharged home. This reflection is not a junior doctor's view of how COVID-19 was managed by the NHS, but a personal view of my illness from 'the other side of the curtain'. My reflections focus upon the psychological aspects of my experiences, exploring the memories that I formed around the time of critical care, how the fears that I possessed were managed with exceptional communication, and the importance of the wider healthcare team in my recovery.

Barrier Techniques to Reduce Aerosolization During Extubation.

Preventing exposure of virulent pathogens during aerosolizing procedures such as intubations has been a cause of concern during the coronavirus pandemic. As such, protocols have been adjusted and precautions implemented in order to minimize the risk to the proceduralist. As patients improve, we face another high-risk aerosolizing procedure-extubation. We illustrate a protocol to help minimize the exposure risk during extubation. We describe a barrier technique during extubation which contained aerosolized particulates into a non-rebreather mask at time of extubation. Our protocol allows providers to perform extubations while minimizing exposure to aerosolized particles.