Teaching Intubation with Cadavers: Generosity at a Time of Loss (In Practice) (Personal Account‪)‬

The baby seemed impossibly small. His estimated fetal weight based on ultrasound had only been a little over one pound, and now, at the moment of his birth, he looked even smaller. His mother had been brought to the hospital in premature labor two days earlier. Shortly after admission, she and her husband had met with me. The three of us spoke at length about outcomes, options, and decisions that must be made. I was willing to attempt resuscitation and intensive care measures, and equally willing to withhold them and provide only comfort care. But the couple asked that everything possible be done to try to save their child, and I agreed to do so. The birth occurred in the early afternoon. A large team from the newborn intensive care unit attended. When he was delivered, the baby was not breathing and his heart rate was very low, so endotracheal intubation was immediately attempted. Intubation of a baby this small is often very difficult, and there is clearly a learning curve. In an academic unit such as this one, the first attempt at a procedure is often done by a trainee. But given the infant's remarkably small size and the presumed difficulty of the procedure, I assigned the task to an experienced practitioner. Nevertheless, the first two attempts at intubation were unsuccessful, and finally I intubated on the third attempt. The infant responded well to the resuscitation--his heart rate increased, as did the oxygen saturation of his blood--and he was taken to the NICU.