Should med students practice tracheal intubation by sticking a plastic tube down a kitten's windpipe? Washington University's School of Medicine is one of the last pediatrics programs in the country that says "yes."
This morning animal rights activists -- in town for a national convention -- stood outside Wash. U's main campus to draw attention to the school's somewhat-antiquated program that trains pediatric students to force open an infant's airways. That program is called "Pediatrics Advanced Life Support" or PALS.
Nowadays most of the top 50 pediatrics programs in the country use simulator dolls to teach students the procedure.
A spokesperson for Wash. U's Medical School says that while using live cats to practice intubation may not sound pretty, it does enhance a student's confidence and skills.
"Students report a cat gives them a better opportunity to visualize vocal cords that are moving and to learn to coordinate intubation with the animal's breathing. They also report greater confidence to deal more adequately with infant and pediatric emergencies," read the statement from spokeswoman Joni Westerhouse. [Full statement below]
But activists on the corner of Skinker and Forest Park Parkway say there are no real learning advantages to using cats, instead of simulators (which are available to Wash. U. students at the Children's Hospital) and they are upset that the university has been unwilling to speak with them.
Peter Young, who served two years on domestic terrorism charges for freeing animals from various Midwest fur farms, says Wash. U. has been "inviting escalation" from activists, who will break laws to protect animals.
"They're practically begging for it," says Young, "just from the way they've been so flagrant about ignoring us."
Young, a 35-year-old from the Pacific Northwest, describes himself as an "unapologetic supporter of those who work outside the law to achieve human, earth, and animal liberation"... so watch out, Wash. U. (even though you were apparently never worried).
Tino Verducci, an Italian activist against speciesism, made his first trip to the United States this week to attend the conference that focused primarily on animal testing. Verducci is responsible for drawing attention to animal abuse at Green Hill Lab, a beagle-breeding farm that was finally shut down by police in April after nearly a decade of fire from animal rights groups.
Verducci says that in his native Italy, you can get 3,000 maybe even 10,000 people to come out to a demonstration for animal rights, so he was surprised to see just 20 or 30 people show up outside of Wash. U. this morning.
"The number is not important," Verducci says. "One person with a banner can make a difference."
One of the demonstration's organizers, Laura Shields (co-founder of St. Louis Vegan) said the group chose to protest in front of the university's Danforth Campus for greater exposure, even though the cat intubation occurs at the medical school in the Central West End.
"This is such an easy campaign to win," Shields says, of the effort to end cat intubation at Wash. U. "People have cats at home. To imagine someone restraining your cat, opening their mouth and cramming a tube down it, must really upset a lot of people."
Indeed, Young says that from an animal rights perspective, ending cat intubation is "like low-hanging fruit for us."
Full statement on PALS from Washington University in St. Louis School of Medicine, on the next page:
Washington University Statement about the Pediatric Advanced Life Support Training Class (PALS): The PALS course at St. Louis Children's Hospital and Washington University School of Medicine uses mannequins and anesthetized cats when training health care professionals to perform life saving intubation procedures in babies.
Intubation involves threading a flexible plastic tube into the throat to help a baby breathe. It requires precision and speed and is achallenging skill to master. The need for competent and confident providers at a baby's bedside at the critical time of intubation cannot be overstated.
To teach medical personnel how to do this procedure, we have them first practice on a mannequin and then on an anesthetized cat. The mannequin is ideal for learning basic techniques, but the cat provides a more realistic experience to what health care providers will encounter when intubating a baby.
Cats have upper airway anatomy and reflexes that closely resemble an infant's, and studies have demonstrated that using anesthetized cats helps improve technique and confidence.
Mannequins offer a wonderful training tool, but we don't believe mannequins are as effective as using mannequins and a live animal. Even the most sophisticated simulator doesn't yet provide the same movements and reflexes of an infant.
When we ask our students to evaluate the life-like characteristics of intubating anesthetized cats and mannequins, they overwhelmingly favor the learning experience with cats, saying it is more realistic. Students report a cat gives them a better opportunity to visualize vocal cords that are moving and to learn to coordinate intubation with the animal's breathing. They also report greater confidence to deal more adequately with infant and pediatric emergencies.
In the 20-plus years we have offered the course, no cat has died or been injured. Veterinarians and vet technicians who advocate passionately for the cats and care for them like pets oversee the lab. The cats live in an open room where they roam freely and are played with by our staff.
The animal lab is short, approximately 20 minutes long, and the cats feel no discomfort. The cats participate a few times a year over a three-year period before being adopted into loving families.
It takes a tremendous amount of time, work and expense to run our PALS course. We have trainees who appreciate our effort and travel long distances so they can attend our course. While we believe animal training is a valuable teaching tool, participants may opt out of that part of the program.
Statement via Joni Westerhouse from WashU's Office of Medical Public Affairs.
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