The practice of teaching endotracheal intubation on recently deceased patients

There are few data available regarding the emergency department practice of using recently dead patients (RDP) for practice and training in endotracheal intubation (ETI/RDP). We investigated several aspects of practice by means of a survey sent to all 5,397 emergency departments in the country. Of the 992 (18.3%) responses, 537 (54.1%) did practice ETI/RDP; 455 (45.8%) did not (P less than 0.005). ETI/RDP was used significantly more commonly for instruction of paramedics (411 institutions [77%]), than for other classes of health providers (P less than 0.0001). Overall, only 69 emergency departments (7%) had any written policy governing ETI/RDP; even among those actually practicing ETI/RDP, 84% had no written policy. Likewise, patients and families were rarely informed of the practice. In institutions where ETI/RDP does occur, only 15 (3%) of emergency departments have a policy which mandates such notification. There was widespread agreement as to the educational value of the practice, although it was more favored in hospitals practicing ETI/RDP than those that do not: 411 of 418 (98%) hospitals practicing ETI/RDP agreed that it was an important component of medical education, as did 240 (80%) of institutions not practicing it (P less than 0.0001). Nearly equal percentages of teaching hospitals (53.8%) and nonteaching facilities (57.9%) engage in ETI/RDP (P = 0.35). Objections to ETI/RDP had been noted in 25% of the institutions where it was practiced.