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Monday, 9 September 2024
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COVID-19 Incident
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Introduction COVID-19 test/demo - Data not saved
You have selected the COVID-19 incident reporting page where you can enter an incident for analysis by ANZTADC. This can also be accessed by your local site for M & M meetings (optional), or yourself (optional), and attracts CPD credits. The de-identified information which will be used to assist with early identification of problems and incidents arising with COVID-19 cases, and summaries will be sent to ANZCA, the ASA and the NZSA for promulgation. The data stored on the ANZTADC server is protected by the quality assurance legislation in both Australia and New Zealand. However you should only enter information that has been fully de-identified and in particular you should not enter the names of patients, medical staff or health care facilities into the Narrative sections. It is possible to log back into the system to view an incident that you have previously entered and add follow up tests, progress or outcomes. In order to protect your privacy, your login details are not stored with the incident that you submit, but instead an anonymous ID will be allocated to this incident. This code will appear at the top of the page when you start coding an incident. At the foot of this page you can set options to email this incident number (but not the incident details) to yourself, or your webAIRS local administrator (if you are a registered site such as a hospital, day surgery or private practice). There is also a text box to record additional information which will be included in the email sent to you, but not stored in the webAIRS database. This will allow further information for local purposes, whilst in the database the data will remain de-identified. Please complete the following form and email options.
Please select one option:
Suspected COVID-19 Case
Confirmed COVID-19 Case
COVID-19 unlikely
COVID-19 issues not directly involving a case
Please select all options for Personal Protective Equipment (PPE) used:
Eye goggles
Eye shields
Gloves - Single layer
Gloves - Double layer
Gown
Hood or body suit
N95/P2 fit tested
N95/P2 fit Checked
Neck protection
PAPR
PPE spotter/buddy for donning and doffing
Other - Please specify below
Other PPE used or problems with PPE:
Airway and Respiratory events - please tick all the options that apply:
Airway Obstruction (other)
Aspiration
Bronchospasm/Asthma
ETT blocked/kinked
ETT endobronchial (unintended)
ETT oesophageal
Extubation problem
High airway pressure
Hypoxia (SaO2<85%)
Intubation difficult
Intubation failed
Laryngospasm
LMA (failed)
LMA (reinserted)
Pneumothorax
Pulmonary Oedema (non-cardiac)
Regurgitation/Vomiting (no aspiration)
Respiratory Arrest (unintended)
Tracheostomy (emergency event)
Ventilation difficulty/failure
Please indicate the method by which you were first alerted to this incident:
-- Please Select --
Observation
Alerted by trainee
Alerted by supervisor
Alerted by Anaes. Assist.
Alerted by surgeon/operator
Alerted by other staff
Monitor SaO2
Monitor CO2
Monitor BP
Monitor ECG
Monitor disconnect
Monitor (audible alarm)
Monitor other
Alarm/Audible device (other)
Sound (other)
Other
Infrastructure and System problems - please tick all the options that apply:
Anaesthetist Unwell
Communication
Distraction/Fatigue/Haste
Envirnonment Unsatisfactory
Environment Unfamiliar
Equipment Unavailable
Equipment Unfamiliar
Equipment Unsatisfactory
ICU/HDU Bed (delay/unavailable)
Pressure to Proceed
Skilled Assist.(delay/unavailable)
Unfamiliar Procedure/Technique
Other problems or issues - please list in the text box below and describe in the Incident Description and Management section:
Patient Demographics
Gender
Male
Female
NoPatient Involved
ASA Grade
..
1
2
3
4
5
Unknown
Urgency
..
Elective
Emergency
Unknown
Patient Age
..
Postconceptual age <44 weeks
PCA 44 weeks to <3 months
3 months to <1 year
1 to 4+ years
5 to 9+ years
10 to 16 years
17 to 29 years
30 to 39 years
40 to 49 years
50 to 59 years
60 to 69 years
70 to 79 years
80 to 89 years
90 years or greater
Unknown
at the time of the incident
Patient BMI
..
< 18.5
18.5-25
25-30: (Overweight)
Above 30: (Mildly Obese)
Above 35: (Obese)
Above 40: (Morbidly Obese)
Above 50: (Super Obese)
Unknown
Incident Description and Management
Contributing factors
(If this is a common problem please include the estimated number of cases per month)
Alleviating Factors
Lessons Learned
Outcome
Type of Incident
Definitions
Incident
Near miss
Unsafe Condition
Not Assessable
An adverse event reached a patient or healthcare worker, whether or not anyone was harmed
An adverse event that did not reach a patient or healthcare worker, and no one was harmed
Any circumstance that increases the probability of an adverse event
It is not possible to assess or not known
Severity
Definitions
Not Applicable
No Harm
Minor Harm
Moderate Harm
Severe Harm
Death
It is not possible to assess or not known.
The event reached a person but no harm was evident.
Bodily or psychological injury resulting in minimal symptoms or loss of function, or injury limited to additional treatment,
monitoring, and/or increased length of stay.
Bodily or psychological injury adversely affecting functional ability or quality of life,
but not at the level of severe harm.
Bodily or psychological injury (including pain or disfigurement) that interferes significantly with functional ability
or quality of life.
Dead at time of assessment.
Severity
Definitions
Temporary Harm
Permanent Harm
Not Applicable
Expected to revert to approximately normal (ie patient baseline); less than one year
Not expected to revert to approximately normal; one year or greater
Email options
Send Incident ID to Self by email
Do not send
The above option will allow you to log into this incident in the future and if required, perform further editing. If you do not wish to send an email you may write the anonymous ID down in a diary or similar record. If you do not record (or know) the anonymous ID, then you will not be able to access this incident again in the future.
Review at department Morbidity and Mortality meeting
Send for department analysis but do
not
review at M & M
Completely Anonymous
To notify your local Quality and Safety officer leave the box above selected.
Additional information to include in the email
If you wish to send any additional information by email to your Local Administrator (and to yourself), then enter the information into the box below. Please note that the information will not be stored in the webAIRS database. However, even though the data isn't stored in the database, it should comply with any relevant data privacy legislation.
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