Postmortem intubation training: patient and family opinion

Endotracheal intubation is a life-saving skill which requires training to master. Learning opportunities for endotracheal intubation must be balanced with patient rights and intentions. This study was conducted to explore patient and family opinions about postmortem endotracheal intubation training.

We carried out an observational, cross-sectional survey study in an urban, teaching hospital, on the day of hospital discharge. Subjects were neurologically unimpaired neurosurgical patients discharged from hospital in 2004-2005, and their relatives. We carried out interviews using a standardised script to determine whether subjects would permit postmortem intubation training on themselves or relatives, and whether permission should be granted by relatives before training.

A total of 85% of patient and family respondents would allow intubation training after death on themselves, 76% would allow endotracheal intubation to be practised on a relative, and 81% felt the deceased's next-of-kin should be asked for permission prior to endotracheal intubation training. Subjects responded consistently as to what they would allow on self and family. Knowledge that the deceased person would have agreed to his or her body being used in endotracheal intubation training increased their likelihood of granting permission for training (P = 0.008). White subjects were 4.6 times more likely than non-Whites to allow intubation training on themselves (P = 0.01).

Patients and families are agreeable to postmortem intubation training; however, most expect to be asked for permission. Utilising existing mechanisms which communicate desired treatment, such as advance directives, hospital admissions documents, donor registries or community health fairs may facilitate training opportunities and altruistic patient intentions.