Using Newly Deceased Patients to Teach Resuscitation Procedures

Análise bioética do uso de recém-cadáveres na aprendizagem prática em medicina

“…It is also as common in Brazil as abroad. 22,23,24 We should also consider that many physicians may have taken this route to learn procedures such endotracheal intubation, deep vein puncture, thoracotomy, tracheostomy, pericardiocentesis, and lumbar and articular puncture; procedures performed secretly, behind screens in public emergency rooms. What does the general public think about these facts?…”

Definitively Defining the Specialty of Emergency Medicine: Issues of Procedural Competency

“…6,7 Maybe it is time to advance procedural skill training and certification using high-risk, standardized national procedural competency exams that might incorporate animal, cadaver, and virtual reality simulation laboratories. [5][6][7][8]10 I contend that we are now ready as a specialty to engage the ABEM in organizing a ''credible developmental research and field testing system on a national level, that could be extended to be a required part of the credentialing and evaluation system of the ABEM.'' 2 With a more sophisticated educational approach, EM specialists can learn to perform procedures as well as or better than other specialists, 2-10 and the ABEM can go beyond what other specialty boards are doing to demonstrate competency.…”

“…Using hypothetical patient case scenarios, they found that 50-80% of their patient population would authorize certain invasive critical emergency procedures to be performed on their newly dead relatives. While it would be expected that approval rates using hypothetical cases would be higher than actual rates, 10 the authors describe a system of presenting procedures with written and pictorial descriptions, possible permanent disfigurements to the body, and whether these disfigurements would be visible on a clothed body at a funeral. It is unclear when best to present the request for consent to family members.…”

“…Some argue that it would be best not to associate the consent when requesting an autopsy, because the goals are different and success rates might be expected to be higher if presented separately. 10 Since not all physicians in our modern era of specialization need to acquire proficiency in resuscitation, such requests for procedures on the newly dead should be performed by those most in need of training -typically EM residents and selective other rotating residents depending on the critical procedure being requested. One could argue that all residents should know how to perform lifesaving cricothyrotomy procedures, just as they should be taught basic life support skills.…”

“…The same lab could be equipped with multimedia and virtual reality capabilities so that the cognitive and visual cue recognition aspects of procedures could be reviewed prior to performing the psychomotor component of the skill on the newly dead. [5][6][7][8]10 In summary, there are inconsistencies in the authorization of procedural privileges based not on skill, but on specialty, and the rules vary from institution to institution. It would seem that now is the time to identify the inconsistencies in the house of medicine by starting within our own specialty.…”