Hergenroeder Georgene W, Prator Bettina C, Chow Alice F, Powner David J
Department of Neurosurgery, University of Texas Health Science Center at Houston, Houston, Texas 77030, USA.
Med Educ. 2007 Dec;41(12):1210-6. doi: 10.1111/j.1365-2923.2007.02936.x.
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.
气管插管是一项挽救生命的技能，需要通过培训才能掌握。气管插管的学习机会必须与患者的权利和意愿相平衡。本研究旨在探讨患者及其家属对尸检气管插管培训的看法。
我们在一家城市教学医院出院当天进行了一项观察性横断面调查研究。研究对象为2004 - 2005年出院的神经系统未受损的神经外科患者及其亲属。我们使用标准化脚本进行访谈，以确定研究对象是否允许对自己或亲属进行尸检插管培训，以及在培训前是否应由亲属给予许可。
总共85%的患者及其家属受访者会允许在自己死后进行插管培训，76%会允许对亲属进行气管插管操作，81%认为在进行气管插管培训前应征求死者近亲的许可。研究对象对于自己和家人能接受的情况回答一致。知道死者会同意其身体用于气管插管培训增加了他们给予培训许可的可能性（P = 0.008）。白人受试者允许对自己进行插管培训的可能性是非白人的4.6倍（P = 0.01）。
患者及其家属同意进行尸检插管培训；然而，大多数人期望被征求许可。利用现有的传达期望治疗的机制，如预先指示、医院入院文件、捐赠登记或社区健康集市，可能会促进培训机会和患者的利他意愿。
