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使用新死亡的婴儿进行插管技能教学。

Teaching intubation skills using newly deceased infants.

作者信息

Benfield D G, Flaksman R J, Lin T H, Kantak A D, Kokomoor F W, Vollman J H

机构信息

Department of Pediatrics, Children's Hospital Medical Center, Akron, Ohio 44308.

出版信息

JAMA. 1991 May 8;265(18):2360-3.

PMID:2016832
Abstract

This prospective study was designed to (1) test the hypothesis that the majority of families of newly dead infants in a tertiary neonatal intensive care unit would consent to their infants' being intubated for teaching purposes, (2) determine factors related to family consent, and (3) determine the effects of participation on resident physicians and respiratory therapists. Family consent for intubation was requested following 44 (80%) of the 55 deaths that occurred during the 10-month study period. Of these requests, 32 (73%) were granted. Proportionately more white than black families consented and consent was positively related to autopsy permission. Fifty-three (75%) of 71 trainees completed a mailed questionnaire after their first intubation experience. Although each respondent found the experience helpful, many reported mixed feelings categorized as doubt about participating, apprehension and discomfort, respect for the body, appreciation for the opportunity, a sense of achievement, and feelings of comfort knowing that consent had been obtained. These findings confirm our initial hypothesis and suggest that (1) newly dead infants can be a valuable resource for teaching intubation skills, and (2) others considering a similar approach need to be aware of and sensitive to trainees' feelings.

摘要

这项前瞻性研究旨在

(1)检验以下假设,即在三级新生儿重症监护病房中,大多数新近死亡婴儿的家庭会同意为教学目的对其婴儿进行插管;(2)确定与家庭同意相关的因素;(3)确定参与对住院医师和呼吸治疗师的影响。在为期10个月的研究期间发生的55例死亡病例中,有44例(80%)在婴儿死亡后请求家庭同意进行插管。在这些请求中,32例(73%)获得批准。同意插管的白人家庭比例高于黑人家庭,且同意与尸检许可呈正相关。71名实习生中有53名(75%)在首次插管经历后完成了邮寄问卷调查。尽管每位受访者都认为这次经历有帮助,但许多人报告了复杂的感受,包括对参与的怀疑、担忧和不适、对尸体的尊重、对获得机会的感激、成就感,以及知道已获得同意后的舒适感。这些发现证实了我们最初的假设,并表明:(1)新近死亡的婴儿可以成为教授插管技能的宝贵资源;(2)其他考虑采用类似方法的人需要意识到并敏感对待实习生的感受。

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