Introduction: During the world-wide coronavirus disease 2019 (COVID-19) outbreak, there is an urgent need to rapidly increase the readiness of hospitals. Emergency departments (EDs) are at high risk of facing unusual situations and need to prepare extensively in order to minimize risks to health care providers (HCPs) and patients. In situ simulation is a well-known method used in training to detect system gaps that could threaten safety.Study Objectives: One objective is to identify gaps, test hospital systems, and inform necessary modifications to the standard processes required by patients with COVID-19 presenting at the hospital. The other objective is to improve ED staff confidence in managing such patients, and to increase their skills in basic and advanced airway management and proper personal protective equipment (PPE) techniques.Methods: This is a quasi-experimental study in which 20 unannounced mock codes were carried out in ED resuscitation and isolation rooms. A checklist was designed, validated, and used to evaluate team performances in three areas: donning, basic and advanced airway skills, and doffing. A pre- and post-intervention survey was used to evaluate staff members’ perceived knowledge of ED procedures related to COVID-19 and their airway management skills.Results: A total of 20 mock codes were conducted in the ED. Overall, 16 issues that posed potential harm to staff or patients were identified and prioritized for immediate resolution. Approximately 57.4% of HCPs felt comfortable dealing with suspected/confirmed, unstable COVID-19 cases after mock codes, compared with 33.3% beforehand (P = .033). Of ED HCPs, 44.4% felt comfortable performing airway procedures for suspected/confirmed COVID-19 cases after mock codes compared with 29.6% beforehand. Performance of different skills was observed to be variable following the 20 mock codes. Skills with improved performance included: request of chest x-ray after intubation (88.0%), intubation done by the most experienced ED physician (84.5%), and correct sequence and procedure of PPE (79.0%).Conclusion: Mock codes identified significant defects, most of which were easily fixed. They included critical equipment availability, transporting beds that were too large to fit through doors, and location of biohazard bins. Repeated mock codes improved ED staff confidence in dealing with patients, in addition to performance of certain skills. In situ simulation proves to be an effective method for increasing the readiness of the ED to address the COVID-19 pandemic and other infection outbreaks.

In December 2019, a pneumonia of unknown etiology was detected in Wuhan, China. This outbreak was then declared an international public emergency in January 2020 by the World Health Organization (WHO), and the announcement activated disaster management plans worldwide. This global crisis created several challenges for the health-care sector. This study reviews the challenges faced by a middle-sized urban academic hospital that are likely present to some extent in all health-care sectors, regardless of their existing disaster plans and policies. While preparing this Saudi academic hospital with a capacity of 192 beds for the emerging pandemic, obstacles arose despite its extensive prior disaster planning and training. Specifically, these challenges were related to health-care workers, supplies, and patient care. We review the actions taken to overcome and resolve these difficulties and provide future planning suggestions for each area to potentially assist other hospitals in their disaster planning and preparedness.

Objectives: This study aimed to describe the development and implementation of a separated pathway to check and treat patients with a suspected/confirmed coronavirus disease 2019 (COVID-19) in the emergency department (ED) at King Abdullah bin Abdulaziz University Hospital in Riyadh. Methods: We conducted a retrospective, descriptive longitudinal study from March to July 2020 by analyzing data of all confirmed cases of COVID-19 among ED visitors and healthcare workers in King Abdullah bin Abdulaziz University Hospital. Results: During the study period, a total of 1,182 swab samples were collected for testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), of which 285 (24.1%) tested positive. Of the 285 cases of confirmed SARS-CoV-2 infection, 18 were healthcare workers and 267 were patients. As a result of using the respiratory pathway for COVID-19 patients, the hospital managed to limit transmission of SARS-CoV-2 not only between patients but also between patients and healthcare workers, while also containing the pandemic. There were no cases of nosocomial SARS-CoV-2 infection recorded among the patients who visited the ED or the flu clinic. All confirmed cases were community acquired and patients were cared for under constrained measures. Conclusions: Implementing infection control measures and restricting those with respiratory symptoms to the ED pathway prevented nosocomial spread of SARS-CoV-2 infection in the ED.

This report describes the medical coverage provided for 10KSA, a charity event held in Saudi Arabia for breast cancer awareness. More than 10,000 women attended the event. A total of 41 attendees sought medical care; four patients (9.8%) presented directly to the clinic and 37 patients (90.2%) presented to the first aid units, mostly for check-ups. This report may be helpful for care providers arranging medical coverage for future events with similar challenging situations (women only, distant location). AlAssaf WI . EMS coverage of a female-only event with 10,000 attendees: preparation and implementation in one week. Prehosp Disaster Med. 2017;32(6):694–698.

Objectives: This study aims to measure health-care students' willingness to volunteer in disaster situations during the Hajj season. In addition, it provides an assessment of the barriers that may prevent them from volunteering, as well as their perceptions of the required skills to be able to volunteer and be a part of response teams. Materials and Methods: This multicenter study, using a convenience sample including 774 students from health colleges in the Kingdom of Saudi Arabia, was conducted between September 2019 and April 2020. Data were analyzed using the SPSS 21. The variables were expressed in percentages as appropriate. A Chi-squared test was used to determine the association between qualitative variables. Results: This study indicates that 95% of health-care students were willing to volunteer during disasters, especially in wound care, patient follow-up, and triage. Their lack of knowledge and skills was one of the obstacles that affected their willingness to volunteer (55.9%). Of the participants, 79.6% would volunteer during the Hajj season, but family agreement, long distance, and fear of cross-infections were the most significant barriers preventing them from volunteering. Students agreed that cardiopulmonary resuscitation and first aid skills should be acquired to render assistance. Conclusions: The willingness to volunteer during disasters is high among health-care students in the Kingdom of Saudi Arabia, even though enormous barriers are preventing them from doing so.

Objective: The emergence of the novel coronavirus disease 2019 (COVID-19) has resulted in precautionary measures by governments worldwide to contain the spread of the virus. However, the degree of compliance toward personal precautionary measures has varied, despite the urgent need to contain the pandemic. This study aimed to assess the level of compliance toward personal protective precautions during and after the lockdown among residents of Riyadh, Saudi Arabia. Methods: We conducted a cross-sectional study with 1,108 residents using an online survey to collect sociodemographic data, compliance with personal protective measures, and other factors during and after the lockdown. Statistical Package for Social Sciences (SPSS) version 26 (IBM SPSS Statistics, Armonk, NY) was used for data analysis. Results: During the lockdown, 35.5% of respondents were “very compliant,” whereas 30.1% were “less compliant.” Additionally, compliance levels in those who depended on official sites as their primary source of information were significantly higher than those who depended on their family, friends, and social media. Approximately 39.76% of those who were “very compliant” intended on getting vaccinated against COVID-19, while 28% of those with high compliance did not intend on getting vaccinated. Further, compliance levels were high in participants who were not in direct contact with COVID-19 cases as well. Conclusion: This study highlights the importance of maintaining the level of compliance toward personal precautionary measures against COVID-19 even after lockdown release to prevent further waves. This study showed that compliance toward personal protective measures was high for those who did not have direct contact with COVID-19 positive people after lockdown, those planning for inoculation, and those insuring applications of precautionary measures by their children. Additionally, higher compliance was noted in participants who sought information from official sites.