A version of this story first appeared in the 2023 issue of On Call, a publication of the University of Tennessee at Chattanooga School of Nursing.
The guy standing next to Dr. Christi Denton at the counter gave her a look that was a bit shocked, a bit confused and maybe a bit frightened.
“I went to Main Street Meats, and I’m talking to the guy behind the counter,” said Denton, assistant professor in the University of Tennessee at Chattanooga School of Nursing. “He said, ‘Are you looking for beef or pork ribs?’ and I said, ‘I don’t know. I’m a vegetarian. What’s more like human?’”
What the man standing next to her didn’t know is that Denton, who’s also coordinator of the adult gerontology acute care nurse practitioner program in the School of Nursing, needed pork ribs to teach students how to properly insert a tube between human ribs to drain fluid or air from the chest cavity. It’s a precarious procedure done in emergency situations when a chest tube is the only thing standing between life and death.
Denton is a critical care nurse who has worked night shifts for 17 years at Erlanger Hospital and an adult gerontology acute care nurse practitioner, herself. She has dealt with dozens of chest-tube emergencies. Pork ribs are the most similar to humans’ when it comes to the “feel” of inserting the tube, she said.
“It’s the most realistic one that I think can mimic humans. There are a lot of sensations that students won’t have until they do it,” Denton said.
During a recent lab in the School of Nursing, students worked on slabs of ribs attached to an artificial human torso, learning the “feel” of using a scalpel to cut through layers of skin, muscle and fat between ribs, then using their fingers to recognize that they’ve reached the chest cavity and are ready to insert the tube.
When the lesson began, the fake torso was inserted into a “patient” with a “medical misadventure,” Denton explained. After four students practiced their skills in different places on the ribs, the patient became a “multiple gunshot victim,” she told the students.
Artificial torsos with plastic skin and foam muscle cost several thousand dollars compared to about $2 to $4 per pound for a slab of pork spare ribs, Denton said. Artificial torsos aren’t as effective as the ribs for teaching students, she added.
“When they simulate this with plastic-synthetic you don’t get the same multilayer feel because on people you have a tough, membranous layer and you feel that ‘pop!’ to go through. Then you have to dissect out muscle,” Denton said. “All of that has a very different feel that they just can’t replicate, but you certainly can on a piece of meat.”
A pig’s trachea—also available at meat stores—can be used for teaching students how to access the airway when going through the ribs won’t work. Intubation or using the trachea to open an airway to the lungs is required to keep a person breathing, Denton said.
Using pork products not only teaches students how it feels to insert a tube between human ribs or into the trachea, but this method also can take away some of the fear when dealing with a real medical emergency.
In these instances, Denton said, “it’s very nervewracking. Someone’s very sick in front of you and the person is dying until you get this done. Simulation, especially with chest tubes or what we do on the pig trachea, gives the student some “real life” experience in a safe space. When they experience this in the hospital, they will have the skills needed to successfully support the patient’s most important function—breathing.”
All thanks to pigs.
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