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29 April 2020 | Story Andre Damons | Photo Supplied
Intubation training on a manikin (Doctors from Department of Anaesthesiology).

The Department of Anaesthesiology at the University of the Free State, in collaboration with the Clinical Simulation and Skills Unit, has trained almost 500 hospital staff members dealing with the Covid-19 pandemic since the lockdown started.

The unit assisted doctors, nurses, and staff working at the Universitas and Pelonomi hospitals with training in the use of personal protective equipment (PPE), including protective clothing, masks, gloves, aprons, and eye protection. The training started the week of 16 March and was led by Prof Gillian Lamacraft, Head of the Pain Control Unit in the Department of Anaesthesiology, and registrars in the Department of Anaesthesiology. Training was not only limited to healthcare workers in hospital wards designated for COVID-19-positive or suspected COVID-19 patients, but workers throughout the hospital received training, lest they be required to care for COVID-19-positive patients in the future, especially if there is an increase in the cases being treated in the hospital.

Training members of the anaesthesia department
According to Prof Lamacraft, the training was initially started to ensure that members of the anaesthesia department would be protected if the need arose for them to wear PPE while treating a COVID-19 patient. Members of the anaesthesia department are not routinely involved in the medical care of patients with serious infectious disease (e.g. Ebola virus), and because they were not previously required to wear PPE regularly, they are not familiar with its use. 
“Internationally, the healthcare workers most exposed to the virus appear to be the ones most at risk of dying, presumably owing to the greater viral load they receive. COVID-19 patients who are severely ill, may require intubation so they can be ventilated – this procedure puts the doctor performing it very close to the airway of the patient, and greatly at risk of being contaminated with COVID 19 during this procedure.” 

“Failure to intubate the patient successfully can lead to the rapid demise of the patient, so it has been decided as hospital policy that anaesthetists will preferably be the doctors performing these intubations, if they are available, as they are considered the doctors best at this procedure. Therefore, anaesthetists will be a group of doctors in the hospital at great risk of COVID virus exposure,” says Prof Lamacraft.

Training other healthcare workers
To facilitate this training, registrars in the Department of Anaesthesiology made videos to demonstrate the donning (putting on) and doffing (taking off) procedure for PPE. Members of the Universitas Academic Hospital’s Infection Control Team provided them with the required information and assessed the training videos for correctness.

The department used the Clinical Simulation and Skills Unit’s facilities at the university to conduct this training, so that the participants could also physically practise putting on and taking off the PPE after watching the videos. 

“Since then, we have been doing this training every working day. Having trained our department, the members of the COVID-19 task team for the Universitas Hospital asked us to train other healthcare workers at the hospital. Accordingly, we have trained many other healthcare workers (over 430 for PPE training alone), including heads of department, professors of medicine, specialists, registrars, medical officers, interns, all ranks of nursing staff, clinical technologists, and household aids.”

The different types of PPE
Prof Lamacraft says it is important that all these healthcare workers are taught the different types of PPE (i.e. standard and aerosol-generating procedure PPE (AGP PPE). In particular, they had to understand that a special type of mask, an N95 mask, should only be used for AGP PPE, as these are in extremely short supply internationally. 

“Many healthcare workers did not know how to put these on correctly, or which size to wear – this had the potential for wastage of this precious commodity. Taking off PPE contaminated with the COVID-19 virus is a very risky procedure. Failure to do so correctly, can lead to not only the healthcare worker contaminating themselves (e.g. by touching their eyes or face while taking off their masks), but also to the contamination of the healthcare workers assisting the person in taking off their PPE; or even to the participant taking home the virus on their bodies and contaminating their family at home. Therefore, the healthcare workers had to be shown how to take off their PPE without contaminating themselves.”
In order to reduce the risk of trainers and other participants being infected during training by healthcare workers who are asymptomatic carriers of COVID-19, only two to four participants have been trained at a time and strict rules were kept regarding social distancing and the use of hand sanitiser.

The training is essential to protect healthcare workers
Prof Mathys Labuschagne, Head: Clinical Simulation and Skills Unit, says volunteering doctors and nurses are also trained to work in ICUs with COVID-19 patients. The ICU department trained these volunteers in the use of ventilators, to assist with putting up drips and lines, intubation, and PPE. The goal is to train healthcare providers to assist in ICU when needed. 

“This training is essential to train and prepare healthcare workers when the patient numbers are increasing. The training is also essential to protect the healthcare workers against infection, because we need them to stay healthy to be able to manage the patients,” according to Prof Labuschagne.

Dr Edwin Turton from the Department of Anaesthesiology says the training is for frontline healthcare workers (nurses, cleaners, porters, doctors, and even washers from theatre) who need to protect themselves in order to protect their patients and all other staff helping them to care for the patients.

“Doctors and nurses need different forms or levels of PPE for working in the clinical environment, and we need them to train to wear appropriate PPE for AGP and contact with PUI and positive patients. They need to be able to protect themselves. The training is for all healthcare workers and not only for doctors and nurses,” says Dr Turton.

News Archive

NRF researcher addresses racial debates in classrooms
2017-03-24

Description: Dr Marthinus Conradie Tags: Dr Marthinus Conradie

Dr Marthinus Conradie, senior lecturer in the
Department of English, is one of 31 newly-rated National
Research Foundation researchers at the University of
the Free State.
Photo: Rulanzen Martin

Exploring numerous norms and assumptions that impede the investigation of racism and racial inequalities in university classrooms, was central to the scope of the research conducted by Dr Marthinus Conradie, a newly Y-rated National Research Foundation (NRF) researcher.

Support from various colleagues
He is one of 31 newly-rated researchers at the University of the Free State (UFS) and joins the 150 plus researchers at the university who have been rated by the NRF. Dr Conradie specialises in sociolinguistics and cultural studies in the UFS Department of English. “Most of the publications that earned the NRF rating are aimed to contributing a critical race theoretic angle to longstanding debates about how questions surrounding race and racism are raised in classroom contexts,” he said.

Dr Conradie says he is grateful for the support from his colleagues in the Department of English, as well as other members of the Faculty of the Humanities. “Although the NRF rating is assigned to a single person, it is undoubtedly the result of support from a wide range of colleagues, including co-authors Dr Susan Brokensha, Prof Angelique van Niekerk, and Dr Mariza Brooks, as well as our Head of Department, Prof Helene Strauss,” he said.

Should debate be free of emotion?
His ongoing research has not been assigned a title yet, as he and his co-author does not assign titles prior to drafting the final manuscript. “Most, but not all, of the publications included in my application to the NRF draw from discourse analysis of a Foucauldian branch, including discursive psychology,” Dr Conradie says. His research aims to suggest directions and methods for exploring issues about race, racism, and racial equality relating to classroom debates. One thread of this body of work deals with the assumption that classroom debates must exclude emotions. Squandering opportunities to investigate the nature and sources of the emotions provoked by critical literature, might obstruct the discussion of personal histories and experiences of discrimination. “Equally, the demand that educators should control conversations to avoid discomfort might prevent in-depth treatment of broader, structural inequalities that go beyond individual prejudice,” Dr Conradie said. A second stream of research speaks to media representations and cultural capital in advertising discourse. A key example examines the way art from European and American origins are used to imbue commercial brands with connotations of excellence and exclusivity, while references to Africa serve to invoke colonial images of unspoiled landscapes.

A hope to inspire further research
Dr Conradie is hopeful that fellow academics will refine and/or alter the methods he employed, and that they will expand, reinterpret, and challenge his findings with increasing relevance to contemporary concerns, such as the drive towards decolonisation. “When I initially launched the research project (with significant aid from highly accomplished co-authors), the catalogue of existing scholarly works lacked investigations along the particular avenues I aimed to address.”

Dr Conradie said that his future research projects will be shaped by the scholarly and wider social influences he looks to as signposts and from which he hopes to gain guidelines about specific issues in the South African society to which he can make a fruitful contribution.

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