Saturday, November 26, 2016

An experimental procedure freezes trauma patients who are bleeding out in order to buy time to operate.

In The New Yorker, Nicola Twilley describes a clinical trial that is currently taking place in Baltimore. That the subjects in the trial cannot consent is an issue that the investigators have struggled with. So is the fact that those subjects will almost certainly be young African American men.

At this point, the patient, his circulatory system filled with icy salt water, will have no blood, no pulse, and no brain activity. He will remain in this state of suspended animation for up to an hour, while surgeons locate the bullet holes or stab wounds and sew them up. Then, after as much as sixty minutes without a heartbeat or a breath, the patient will be resuscitated. A cardiac surgeon will attach a heart-lung bypass machine and start pumping the patient full of blood again, cold, at first, but gradually warming, one degree at a time, over the course of a couple of hours. As soon as the heartbeat returns, perhaps jump-started with the help of a gentle electric shock, and as long as the lungs seem capable of functioning, at least with the help of a ventilator, the patient will be taken off bypass.

Even if everything works perfectly, it will take between three and five days to determine whether the patient’s brain has been damaged, and, if so, to what extent.

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