The performance of procedures on the recently deceased

Abstract

Objective: To determine the prevalence of performing procedures on the recently deceased for training purposes in emergency departments (EDs) with emergency medicine (EM) training programs.

Methods: Surveys were mailed to program directors of Accreditation Council for Graduate Medical Education (ACGME)-approved residency programs in EM. A check-off system was used to identify which procedures were performed and who performed the procedure. The survey also documented whether consent was obtained and whether written policies exist that address this issue. A Likert scale was used to evaluate respondents' attitudes toward this practice.

Results: Ninety-six (83%) of 116 surveys were returned. Forty-seven percent of the respondents indicated procedures were performed on the recently deceased for teaching purposes in their EDs. Emergency medicine residents perform the procedures in all departments where this practice occurs, with off-service residents and medical students using this technique in half of those departments. Paramedics, flight nurses, and attending physicians occasionally use this resource. Endotracheal intubation was the most commonly performed procedure. Seventy-six percent stated they "almost never" obtain consent from family members. Only four of 96 respondents have written policies concerning this practice. The majority of program directors (69%) would favor a position statement from a national EM organization concerning this issue, while 11% were opposed.

Conclusions: The performance of procedures on the recently deceased is a common and important practice in EM training programs. Consent is infrequently obtained and policies concerning this practice are rare and restrictive when present.