Animals in Pediatric Residencies

The Physicians Committee

Animals in Pediatric Residencies

The primary emergency procedure taught in pediatric residency training is endotracheal intubation, a medical procedure in which a tube is placed into the windpipe (trachea) through the mouth, or sometimes through the nose. In the past, most pediatric residencies used cats or ferrets to train their residents in this procedure.

Animals are typically used over and over for intubation training. Animals used in these training procedures often suffer tracheal bruising, bleeding, scarring, severe pain, and even death. The anatomical differences between these animals and humans render this type of training ineffective.

Moreover, specifically developed simulators can completely replace the use of animals in pediatric residency programs. In fact, studies have shown that these simulators are educationally superior to the crude and outdated methodology of using live animals.

Louis Halamek, M.D., F.A.A.P., co-chair of the American Academy of Pediatrics’ Neonatal Resuscitation Program steering committee, and his colleagues stated in 2000 that “[r]ealistic simulation-based training in neonatal resuscitation is possible using current technology, is well received by trainees, and offers benefits not inherent in traditional paradigms of medical education.”1 Given the subsequent development of Laerdal’s SimNewB and other neonatal simulators designed to teach endotracheal intubation, Dr. Halamek’s statement is even truer today than it was at the time.

More recently, Cindy Tait, R.N., M.P.H., one of the developers of the American Heart Association’s Pediatric Advanced Life Support (PALS) course, remarked: “The bottom line is that there is no need to traumatize and harm animals to teach [intubation and airway management skills], especially when highly effective non-animal methods are the accepted standard of practice and readily available to instructors.”2

Furthermore, studies have demonstrated that those who engage in simulator-based training display great proficiency in intubation compared with those who train with either animals or even human patients. The authors of a 2001 study noted that the oropharyngeal anatomy of animals differs vastly from that of humans, and as a result intubation techniques used in animals are also different from that used in humans.3

Another study found that transport team members who were trained on simulators displayed higher proficiency in pediatric intubation (92 percent overall) than pediatric residents  who had learned pediatric intubation using cats (77 percent overall).4 The authors noted that “[t]raining on mannequins allows for greater concentration by the trainee on technique. Without the urgency to place the tube, which is felt when practicing on animals or humans, the trainee is much more open to suggestions or corrections.”

1. Halamek LP, Kaegi DM, Gaba DM, and others. Time for a New Paradigm in Pediatric Medical Education: Teaching Neonatal Resuscitation in a Simulated Delivery Room Environment. Pediatrics 2000; 106(4) e4.

2. Tait C. On the differences between a child and a kitten. J Emerg Nurs 2010; 36(1): 78-80

3. King B, Woodward G. Procedural training for pediatric and neonatal transport nurses: part 1-training methods and airway training. Pediatric Emerg Care 2001; 17(6): 461-4.

4. Adams K, Scott R, Perkin RM, Langga L. Comparison of intubation skills between interfacility transport team members. Pediatr Emerg Care 2000; 16(1): 5-8.