Factsheets

Endotracheal Intubation Training: Maiming and Killing Animals

Endotracheal intubation, a procedure in which a tube is passed through the mouth or nose into the trachea, is used on people who are experiencing breathing difficulties or those who require respiratory support. Unfortunately, many cats, kittens, and ferrets are still used to teach intubation to medical care providers, even though more effective and humane training methods exist.

Chronic Injury or Death
Animals are alive while undergoing intubation, and most are used over and over again. Improperly anesthetized animals can and often do suffer at the hands of inexperienced students during training. Even when properly anesthetized, animals may suffer tracheolaryngeal bruising, collapsed lungs, bleeding, scarring, severe pain, and chronic coughing. In some cases, animals die after being improperly intubated. Often, animals are repeatedly intubated during a single session by more than one student, increasing their chances of injury.

Dangerous Differences
The anatomical differences between cats, ferrets, and humans are too great for students to be able to apply the skills that they learn on animals to humans. Cats have larger, sharper teeth, proportionately larger tongues, more copious salivation, smaller anterior larynxes, dome-shaped arytenoid cartilage, and larger epiglottises than humans.
 
Where the Animals Come From
Some animals used for intubation practice are former animal companions who were obtained from animal shelters. Animal shelters should be sanctuaries for homeless animals, not supplyhouses for laboratories and teaching hospitals. Others come from biological supply companies, where they are bred, confined to cramped cages, and then shipped off to various facilities to be abused in medical training and experimentation.

Modern Training Methods
Increasingly, medical professionals object to the use of animals in training for financial, ethical, and educational reasons. The president of the Center for Healthcare Education (CHE), a developer of the Pediatric Advanced Life Support (PALS) course, has stated that the CHE is “adamantly opposed to the use of live or even dead animals in the American Heart Association PALS curriculum,” because “there [have] been no scientific studies proving that training on live animals is superior to human cadaver or manikin training.”(1)

Cost-effective, anatomically accurate manikins are readily available for intubation training and represent the most common and effective training method. These models provide an exact replica of human anatomy and allow students unlimited opportunities to practice intubation and other procedures. According to an Annals of Emergency Medicine study, the endotracheal intubation (ETI) success rate achieved by paramedics who were exclusively trained on manikins was 86 percent. The authors conclude, “Our study supports the concept of using only manikins and didactic sessions for teaching the skills of ETI to paramedics.”(2)

A manikin can be intubated repeatedly by many individuals and training classes without risk of harming the subject. With proper care, manikins can be used indefinitely, making them much less expensive than animals.

Training on cadavers is another option and provides valuable practice on an actual human body, allowing trainees to see the location and size of the components of the human oropharyngeal cavity.
 
What You Can Do
If you are in nursing or medical school and will be expected to undergo intubation training, raise your objection to using animals as soon as possible. List, in writing, your reasons for objecting, and recommend the use of manikins 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 about the use of animals for intubation training but are not in the health-care field, you can raise the issue in your community. Write letters to the editors of local publications, explaining that excellent alternatives are available. Ask your local hospital or training institution to use manikins or cadavers.

References
1) Cindy Tait, e-mails to PETA, 16 Jul. and 26 Aug. 2008.
2) Samuel J. Stratton et al., “Prospective Study of Manikin-Only Versus Manikin and Human Subject Endotracheal Intubation Training of Paramedics,” Annals of Emergency Medicine, 20 (1991): 1314-17.