OB Crisis Team Training Exercise
Equipment/Planning Guide
Several Weeks Prior to Training
 Verify everyone is available (See if personnel can be freed from clinical responsibilities, think
about substitutes if critical personnel are unavailable)
o Pediatrician
o All nurses you would typically need (minimum of 3 )
 Tertiary care center
 Baby
 OB primary
 Circulator
 Scrub
 Community
 1-2 OB nurses on the unit
 Nurse Supervisor
 ?Surgical/PACU nurse
o Anesthesia
o OB provider
o Surgical Assistant
o Respiratory
o Laboratory
o X-Ray
o ED Doctors if they are part of the response emergency team.
o Trainer: This is the person that will be feeding personnel the scenario. This should be
either a very senior nurse or provider. They need to be medically realistic in the drill.
o Recorder: This person will be documenting times. Tap someone from QA/QI in our
hospital.
o Videographer: this person will be doing the video. You can use a home video. Again,
use someone from QA/QI
 Verify Manikin/Simulator is available. You could use the head/chest of CPR Annie and then
put a pelvis below it in the bed. This makes transport fun!
 Create a fake chart (materials are provided... put them into your standard chart)
 Make sure appropriate hospital departments know a drill is going to happen
o Switchboard
o Anesthesia
o OB
o OR
o Pediatrics
o Laboratory
o X-Ray
o ED Team
o Respiratory

o Nursing Supervisor/House Supervisor in Small Hospital, Nurse Manager in a large
hospital.
See if you can get a video camera with an LCD project or TV to use
One Week Prior to Training
Confirm everyone is coming and equipment is available
Setting the Stage on the Day of Training
LABOR ROOM
 Manikin in a bed. Use a labor bed.
 IV pole with several pumps and an epidural setup. Have IV bags hooked up to pumps.
 Fetal Monitor: You can tap out the fetal heart rate on the external monitor by putting some
gel on it.
 Code Cart
 Pediatric Resuscitation Cart
OB FLOOR
 Patient Chart
 Isolette
 TV/LCD set up to review video tape
OPERATING ROOM: Have whatever it typically has in it when it is empty. Make sure that you
have supplies you are allowed to open and use.
Points to Focus On
 Assign roles at the beginning of the session.
 Review the emergency delivery guidelines before doing the simulation, to get personnel
oriented to what they should be doing.
 Speak back
o Identify who the order is given to by name
o Person completing task verbalizes that he/she is doing it
 This can also be used to simulate doing tasks: ie putting catheter in dummy
or fetal scalp clip on)
 Rotate roles, this lets personnel see how difficult other roles are.
 Run 2 simulations in a row. The first one is just to get personnel moving (it rarely goes well).
The second one is the one to analyze.
 Use the simulation to refine the steps you need to do for a stat cesarean section. Use the
emergency delivery guidelines as a place to start. Create your own process map. This will take
several months if you are like most hospitals.
 Start simulations with a core group of constant people for the first 3-4 sessions. This will
shorten the learning curve. Once you have it all figured out, then open it to the entire staff.
When Resources are Limited (ie Time, People)
Focus on small steps of the process
 Pt out of Room
 Paging System notification
o Extremely important to test this
o Do you have call backs?
o Every institution needs to have a testing system that right personnel are on call and
carrying a pager.
 OR Set UP
 Pediatric Resuscitation
 Family Debriefing
Have a back up plan on simulation day if resources are tied up
 Fake OR, etc. if the main one is tied up
 Different Plan for the session: Ie. discuss a part of emergency delivery that remains a problem,
and what you can do to fix it.