Exploring the Heart and Lungs

Dissection Day At the Simsbury Ambulance EMT class

Heart and Lungs are hard to get. If you wish to procure them from a Slaughter house, you must fill out copious paperwork with the USDA IF you can find a "meatman" that says yes. In my early Teaching career, every single slaughterhouse, meat market, and butcher shop said no...They wanted no part of giving or selling organs for medical specimens. Because of this "ban on consumption". collecting samples is impossible for an EMS Instructor, high school A&P teacher, or a college professor. I teach at a university and the faculty heads have not been interested in pursuing the process due to the assumed difficulty. Meanwhile, at Farm Life Farm, we can harvest our own. For the past five years or so, I have been harvesting heart/lung/great vessels from our sheep and pigs to bring to EMT classes for inspection and dissection. Pigs are my choice as they are just about a 1:1 size ratio to humans based on body weight. Sheep are slightly smaller but mammals just the same.

This is now a highlight of my classes and has developed into a great training session.

We begin with a viewing and palpation. We let the students feel the tissue and get a good look at it; stick their fingers into the Aorta and follow it back to the valve in the Left Ventricle. We go over the anatomy and emphasize the lung lobes and the four chambers of the heart.

About half the time I am able to keep the larynx in tact. I can then show our EMT students how we intubate and where the tube actually seals at the vocal cords. If not, we simply place the endotracheal tube into the trachea. We then ventilate with the BVM and practice ventilations. I have found no better way to prove how little volume it takes to begin visible inflation. This moment provides clear insight into why we work so hard not to over-inflate the lungs. When they push a full 1,000mL of air into the free-to-expand lungs, the heart that is already surrounded by the lungs. disappears, completely enveloped in pressurized lung tissue. Normal lung function deteriorates rapidly when we stab the lungs simulating the pneumothorax. Practicing BVM ventilations offers a real experience for the additional difficulties the pneumo brings to the party.

The next step is to dissect the lungs. We cut sections apart and look at the bronchi and bronchioles and blood vessels. It is impressive how intimate they become with the tissue. Even those that are squeamish or disgusted at the onset become determined to understand what every little tube is and color difference mean. These are moments that remain in an instructor's soul. Moments when you clearly got through to them and have an entire class engaged are magical.

Experienced Responders Explore the heart and lungs

The heart is next. We start with the pipes in and out and the four chambers. Repeating the route of travel our blood takes through the two systems. a syringe of warm water injected into the vena can be pumped out with some manual compressions. I then cut it in half and allow the students to inspect the heart  valves and chambers. I use this to re-enforce the concept of two separate pressure systems between the lungs and the body. We dissect the coronary arteries and look for signs of atherosclerosis. (My animals are pasture raised and eat all natural diets. There is no plaque, unfortunately. I should isolate a pig and feed it an American diet with snacks and McDonalds and soda. Though Peta would probably sue us. We finish up the event with time for the participants to do any final investigations while I meander to field additional questions. Oh, I almost forgot. Have you ever tried to guesstimate how much blood is in the puddle next to your patient? Probably not if your office is not a van with a bed and flashing lights. In this training, we inevitably have a puddle of blood sitting on the table at different stages of coagulation. We can play the price is right and then pour/scrape it into a graduated cylinder and see how much it really is.

This is such a great event. I wish I had the ability to make this sort of thing standard practice. The educational experience cannot be compared to a video or pictures or even silicone replicas. There is nothing like the real thing.

A moment with me on a soap box: Every EMT class should have a dissection day. What is such a common foodstuff in the rest of the world remains both criminal and taboo in our country. And I mean both as separate but equal impediments. In the very near future I will be sharing a souffritto recipe that has been in my family for many generations. While I do understand the concern of gastric aspiration pre-mortem, and the rare instance of heavy metals toxicity, I also understand that like virtually all of what our government has told us since 1903 has been scripted propaganda and cultural control. Fluoride was proven beneficial with one short term study in one small town. This ban was similar with no call from the public. The fact should be that a teacher certificate or an EMS Instructor certificate is all that a slaughterhouse needs to hand them over. The complete, unequivocal ban goes so far above the possible health risk that I cannot logically understand. Sadly this will remain a very unique opportunity afforded only to those students of the operators of Farm Life Farm.