Even for a simulation expert, some of the findings were unexpected.

“I was surprised to learn just how much contamination of exposure particles can occur in areas we don’t think of covering – the neck, the feet,” Dr. Arnold said.

While the article was aimed at anesthesiologists, anyone providing care for patients with COVID-19 can learn from it, said Dr. Paul Phrampus, a professor in the department of emergency medicine and director of the Winter Institute for Simulation, Education and Research (WISER) at the University of Pittsburgh.

“What’s nice about it is it informs the entire medical community that when these procedures are being done, you need to pay strict attention to what PPE is recommended and also to the procedures for putting on and, most important, the procedures for taking off since this is when most contaminate themselves.”

“As a simulation professional as well as a practicing physician, I would like to continue to advocate for simulation centers to be doing these kinds of studies to inform us as we move forward during these trying times,” Dr. Phrampus said.

Dr. Phrampus and his team have been running through simulations themselves.

“All day yesterday and today we were looking at system sequences involved in the intubation of patients – who goes in the room and when, choreographing movements,” he said. “We probably ran the drill 20 times to refine the sequences so that we do them better and safer.”