38 - Setting up and running labour ward fire drills

Summary

Fire drill programmes using simulation of patients and clinical scenarios are useful for training doctors, midwives and allied staff to manage critical emergencies effectively. Umbilical cord prolapse, shoulder dystocia, obstetric haemorrhage, eclampsia and undiagnosed vaginal breech, sudden postpartum maternal collapse, unexpected poor neonatal outcome are some key areas where fire drills can be used. Fire drill sessions provide an environment where algorithms and management guidelines can be discussed, revised and improved. An example of a labour ward fire drill in an 'all-resource' setting with shoulder dystocia as a scenario is described. Pendleton's principles provide a structured interactive approach of giving feedback. Fire drill sessions provide an environment in which protocols and guidelines can be reviewed and revised and helps identify and rectify organisational or system factors that may contribute to poor outcome during an obstetric emergency.