|
This factsheet was completed by People for the Ethical Treatment of Animals (PETA). Please direct any questions or comments to PETA directly at 757-622-7382 or info@peta.org.
Endotracheal Intubation: Killing Cats & Kittens
Endotracheal intubation, the passing of a tube through the mouth or nose into the trachea, is a necessary procedure for people who experience breathing difficulties or need respiratory support. Many cats and kittens and some dogs, ferrets, and pigs are still used to teach intubation, although better training methods exist.
Chronic Injury or Death
Even when properly anesthetized for veterinary care, animals may suffer tracheolaryngeal bruising, bleeding and scarring, severe pain, and a lingering cough. Improperly anesthetized animals can and often do suffer at the hands of inexperienced students during intubation training. In some cases, animals die from being improperly intubated. Often, animals are repeatedly intubated in a single session by more than one student, increasing the chance of injury.
Modern Training Methods
Several non-animal training methods available for teaching intubation combine hands-on training using mannekins, human cadavers, or actual patients with lessons covering important background and theoretical information, often including overhead transparencies, slides, equipment demonstration, and a question-and-answer period.
Mannekin training uses specially designed, anatomically correct models. A mannekin can be intubated repeatedly by many individuals and training classes, without fear of harming the subject. With proper care, mannekins can be used indefinitely, making them less expensive than animals. Holly Jensen is one nurse who supports the use of mannekins because "repetition and review are among the most important components in both acquiring and maintaining competency when learning intubation. . . . When a live teaching subject is used, most students refrain from repeating the procedure because of the obvious traumatic implication associated with an entire class subjecting a few animals to this over and over again. With the [mannekin] infant head simulator, however, students have no hesitancy in practicing until proficiency is obtained." (1) Sarah Krakauer is another nurse who says, "People can learn intubation at least as well on non-animal models as on living creatures. Using models is less expensive and solves the problem of anatomical differences between cats and babies." (2)
Training on a cadaver provides valuable practice on a physiologically relevant form. Trainees see the actual location and size of the components of the human oropharyngeal cavity. Staff members of the neonatal intensive care unit of Children's Hospital Medical Center in Akron, Ohio, found that 73 percent of parents would allow the use of their babies who could not be saved "if it helps other babies in the future," as one parent said. (3)
Training in the operating room occurs only after mastery of one or more of the other training methods. Intubation on living humans is usually observed first, then performed under the direct supervision of an anesthesiologist.
Dangerous Differences
Clinicians should receive adequate training on physiologically relevant models before intubating human patients, but the anatomical differences between cats and humans are too great to apply to humans the skills learned on cats. Cats have larger, sharper teeth, proportionately larger tongues, more copious salivation, smaller anterior larynxes, dome-shaped arytenoid cartilages, and larger epiglottises than humans.
Opposition to the use of animals for intubation training is growing. One practicing veterinarian objects to the use of cats because "unlike man, the cat is most easily intubated while lying in sternal recumbency [on the stomach]. . . . During this procedure, cats are extremely susceptible to laryngospasm, which, if it occurs, makes intubation impossible. The sensitive tissues of the larynx and pharynx can be severely bruised if intubation is attempted during laryngospasm. . . . I do not recommend that the cat be used to teach human endotracheal intubation." (4)
On July 29, 1993, New York Governor Mario Cuomo vetoed legislation that would have allowed medical technicians to practice intubation on cats. Aides to Mr. Cuomo said he received more mail and phone calls on the bill than on almost any other piece of legislation. (5)
Where They Come From
Animals used for intubation practice may be former companion animals obtained from shelters. Shelters should be sanctuaries for homeless animals, not supply houses for laboratories and teaching hospitals. Cats can also come from biological supply companies, the largest of which have been implicated in cruelty to animals. The demand for cats to teach intubation training also encourages theft of companion animals and breeding of cats, worsening the companion animal overpopulation problem.
What You Can Do
If you are in nursing or medical school and will be expected to intubate in your training, raise your objection to using animals as soon as possible. List in writing your reasons for objecting, and recommend the use of mannekins instead of animals. Call Medical Plastics at 1-800-433-5539 or Armstrong Medical Industries at 1-800-323-4220 for a list of intubation models and prices.
If you are concerned with the use of animals for intubation training, but are not in the health-care field, you can raise the issue of animal use in your community. Write letters to the editor explaining that excellent alternatives are available. Ask your hospital or training institution to use mannekins or cadavers.
For more information, contact People for the Ethical Treatment of Animals.
References
- Jensen, Holly, R.N., written statement.
- Krakauer, Sarah, R.N., written statement.
- Canuto, Phillip E., Beacon Journal, May 14, 1991.
- Thacher, Wendy, D.V.M., written statement, Feb. 5, 1991.
- Dao, James, "Cuomo Veto Spares Trees at Expense of Billboard Views," New York Times, July 30, 1993.
|
