U.S., Canada, begin trauma experiments

UPI ^ | 05/27/07

[nypokerface]

WASHINGTON, May 27 (UPI) -- The U.S. government is undertaking a set of controversial studies that allows some medical experiments without getting patients' permission.

The $50 million project aims to improve treatment after car accidents, shootings, heart attack and other emergencies, the Washington Post reported Sunday. The five-year project will involve more than 20,000 patients at 11 sites in the United States and Canada.

The experiments aim to find better ways to resuscitate people whose hearts suddenly stop, to stabilize patients in shock and to limit damage from head injuries, the Post reported.

The patients often are unconscious at a time when every minute counts, so it can be impossible to get consent from them or their families, said organizers of the studies. The project is supported by many trauma experts and some bioethicists, while the harshest critics say the experiments violate fundamental ethical principles.

The U.S. National Institutes of Health authorized the study for medical centers doing research in Seattle, Portland, San Diego, Dallas, Birmingham, Pittsburgh, Milwaukee, Toronto and Ottawa, and in Iowa and British Columbia.

[cripplecreek]

I’ve got mixed feelings on this one. Experimentation has long been a regular part of trauma medicine.

I know a trauma surgeon at UofM University hospital. He explained that most people that are considered trauma patients have little chance of surviving (usually in the 10% range). 30 years ago slitting a severely injured patient from groin to collarbone was unheard of but they began doing it. They found that they were able to locate life threatening internal injuries that may not show up immediately.

It’s just an example of experimentation like that leading to higher survival rates.

[ga medic]

I am not sure exactly what kind of experimentation they are referring to. There are occaisions when a trauma patient will not survive, when new or experimental procedures are tried. I know that spinal cord injuries have a much higher chance of survival because of some early experiments. Injecting the spinal fluid with steroids immediately has now proven to reduce injury and provide a much better diagnosis.

As for consent, if available we always try to get consent from either the patient, or available family. If we can’t and the patient will almost certainly die, we will try whatever we can to keep the patient alive until a relative is reached. If there is a possible treatment out there, which might help, this is the perfect time to give it a try. Sometimes it works really well too.

[cripplecreek]

He was talking more about early trauma medicine. Obviously consent is important but the guy who gets drunked up and swats a tree at 120mph often comes in on the life flight with little information.

The surgeon I know got his early trauma training in Vietnam where it was all about speedy transport, stopping the bleeding and stabilization.

[Siobhan]

It is evil plain and simple.

This is merely the part they tell us about. Of course, that’s just the tip of the iceberg. I have no faith in any of them, and anyone who does must still be asleep to the madness afoot.

[ga medic]

“The surgeon I know got his early trauma training in Vietnam where it was all about speedy transport, stopping the bleeding and stabilization.”

Still the same objectives. It used to be when I was only FF and not paramedicine, that stabilization was necessary before transport. That changed many years ago, and speedy transport is the main objective now. Stabilization is still a goal, but not necessary to transport.

They are doing amazing things in Iraq with trauma medicine, and are saving the wounded in record numbers. These techniques will take a while to reach general practice, but they will get here. One of the benefits of war, I guess.