This New Emergency Procedure Literally "Pauses" Life

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slide2 (1)Illustrated by Anna Sudit.
If you've ever watched ER or Grey's Anatomy, you know one of the most poignant, frustrating things about being a doctor: Time is never, ever on your side. Despite the best efforts of ER docs, nurses, and trauma surgeons, patients can be doomed if they arrive at the hospital even one minute too late. But, doctors may soon be able to turn back the clock for trauma victims — or, at the very least, press "pause."

The trauma team at Pittsburgh's UPMC Presbyterian Hospital has been given the go-ahead on a trial for a new type of treatment for patients whose hearts have stopped beating after a traumatic event (like a car crash, a gunshot, etc). Under normal circumstances, there is little that can be done for such patients; doctors have a very short window with which to treat them, and they usually face only a 7% chance of survival. In the new trial, when such a patient arrives at the emergency room, doctors will immediately drain the individual of his or her remaining blood, replacing it with cold saline. This process basically freezes the body, preserving the essential organs while doctors work to repair the damage caused by the trauma. In a literal sense, the patient is in a state of "suspended animation": not alive, because his or her heart is not beating — but not dead, either.

Doctors then have an additional two hours or so to complete surgery. Afterward, they replace the cold saline with blood via a transfusion. Previous experiments testing this process on pigs suggest that, most of the time, the heart will start back up on its own; if it doesn't, doctors expect to be able to successfully resuscitate the patient.

While scientists have discussed the potential of a process like this for more than a decade, it's taken a long time to get a major trial approved, mostly because of legal issues concerned with getting consent from patients and families in an emergency. For the purposes of this trial, because these patients have such a low survival rate, the FDA has ruled this treatment exempt from "informed consent" laws, meaning that doctors don't need to inform patients or their families that they're using this method. That said, there is an option for people to opt out of the procedure.

However, doctors are hopeful that the trial will produce similarly positive results to that of the pig study. Needless to say, if this is a success, emergency medicine will never be the same — and we'll be able to save countless lives that would otherwise have been lost, just because the clock ran out. (New Scientist)