JOINT BASE SAN ANTONIO-FORT SAM HOUSTON, Texas —
Respiratory therapists the world over have been called to the frontlines in the battle against the novel coronavirus, known as COVID-19. Preparing to join the fight are 27 military respiratory therapists students in class 19-015 who graduate training May 7.
The Army/Navy consolidated respiratory therapist program teaches students the skills necessary to function as competent respiratory therapists in critical care areas. The 32-week program is divided into two phases of training.
The first 16-week phase is the didactic portion conducted in the classroom and simulation laboratories at the Medical Education and Training Campus, or METC, at Joint Base San Antonio-Fort Sam Houston, Texas.
Training involves classroom instruction and hands-on practice in the program’s mock intensive care units that utilize realistic, hi-fidelity manikins that simulate ICU patients. The manikins can be programmed to present a variety of vital signs and symptoms, as well as talk, cough, and make other sounds.
Phase 2 is the clinical training at the Brook Army Medical Center, or BAMC, where students apply their classroom and lab training in a variety of supervised clinical settings that involve hands-on patient contact.
Students rotate between different departments to gain more in-depth experience and knowledge of respiratory issues, to include hospital wards, intensive care units, pulmonary function laboratory, pulmonary rehabilitation, and a sleep laboratory.
It was toward the end of phase 2 clinical training for respiratory therapist class 19-015 that medical facilities began to postpone non-invasive and non-urgent procedures in support of the national COVID-19 response. Many departments in the students’ clinical rotations at BAMC were either reducing or no longer seeing patients.
The new policy created a dilemma for the students who needed to complete their clinical rotations to graduate.
Like many educators who were compelled to think outside the box as schools began closing, the respiratory therapist clinical instructors sought to create a workaround to this unique situation.
“The instructors wanted to ensure that training didn't cease during the COVID-19 pandemic,” stated Staff Sgt. Joshua Dixon, non-commissioned officer in charge of respiratory therapist phase 2 clinical training.
So, they came up with a plan. The students would return to METC to complete their clinical portion in the simulated ICU labs.
“With the reduced capabilities and to ensure the safety of our students, we chose to utilize the phase 1 mock ICUs at METC in order to test the students’ abilities as newly trained respiratory therapists.”
Dixon explained that to comply with social distancing guidelines, the class was split into smaller groups and each student assigned a specific time to conduct the simulation training.
Eight labs, or stations, were set up, each with a different scenario and staffed by the phase 2 clinical training instructor who normally teaches that scenario. One student was assigned to each of the stations and had 10 minutes to work the scenario. When time was up the students rotated to the next station. It took 80 minutes to complete all the scenarios.
During the rotation, students were expected to troubleshoot a ventilator, assess a trauma patient, participate in a code blue emergency, attend a mock pre-term neonatal delivery and resuscitate the newborn, assist with a bedside bronchoscopy, intubation and extubation of a patient, and perform non-invasive ventilation. A COVID-19 scenario was also incorporated.
“It was well put together by the instructors," expressed Sgt. Jasmin Fabre, one of the RT students in the class, who thought the scenario simulations were worthwhile. "This training helped me with the application of skills that respiratory therapists possess in lieu of seeing live patients.”
It is unclear whether phase 2 training will return to normal for the next class, but Dixon is hopeful that his team will be prepared.
“If restrictions are not lifted we will discuss how we will go about training during this pandemic,” he stated. “We’ll be ready.