OHSU Resuscitation Studies Conducted at Scene of Incident Continue to Enroll People
12/15/08 Portland, Ore.
Studies are conducted by paramedics in four-county Portland metropolitan
Both studies are part of the National Institutes of Health-funded Resuscitation Outcomes Consortium. The ROC comprises 10 regional medical centers in the United States and Canada that seek to find promising scientific and clinical advances to improve survival from cardiac arrest and severe trauma. Portland was designated a ROC community in 2004.The first study is looking at methods of resuscitating people with traumatic head injuries. The current standard of care for treating people with these injuries in the field is to intravenously administer saline (water with the same salt content as blood). The study is determining whether hypertonic saline (water with a higher salt content than blood) or hypertonic saline with dextran (an added sugar molecule) will improve survival or brain function recovery. It is believed that hypertonic saline might allow blood flow to be restored with a smaller amount of fluid than regular saline. In addition, it is believed hypertonic saline may reduce inflammation following an injury.
Since the hypertonic saline study began in January 2007, 153 people have been enrolled in the Portland metropolitan area. Researchers hope to enroll about 2,300 people across all ROC sites before the study ends. This study was originally enrolling people who were in shock following a traumatic injury as well as those with severe brain injuries. The shock portion of the study stopped enrolling people this fall.
The second study, called ROC PRIMED, is looking at methods of resuscitating victims of cardiac arrest. One part of the ROC PRIMED study looks at the use of cardiopulmonary resuscitation (CPR) before and after delivering an electrical shock to restart the heart of someone experiencing an abnormal heart rhythm (ventricular fibrillation). The second part of the ROC PRIMED study is testing the use of an impedence threshold device (ITD). The ITD is a small, plastic device that fits onto the facemask or breathing tube used during CPR. The device may allow more blood flow back to the heart during the decompression phase of CPR, allowing more blood to circulate during the compression phase.
Since the ROC PRIMED study began in June 2008, 321 of an anticipated 600 people annually have been enrolled. Researchers hope to enroll about 16,500 people across all ROC sites before the study ends.
Individuals eligible for enrollment in these studies are unable to provide consent to be in a research study due to their conditions. Because of this, the studies are being conducted under Food and Drug Administration (FDA) guidelines that allow research in certain life-threatening situations without pretreatment authorization.
Currently emergency medical services agencies across North America use slightly varying methods to treat patients. The ROC allows studies to be conducted in rural and urban areas simultaneously, thus allowing a large number of diverse individuals to be enrolled and results to more quickly guide future practice. Emergency Medical Services agencies and hospitals in Multnomah, Clackamas, Washington and Clark counties are working together to conduct this research.
“This research will directly impact the lives of Oregonians by helping us learn how to improve the quality of life and chance of survival from sudden cardiac death and seriously injured patients,” said Terri Schmidt, M.D., principal investigator, Greater Portland ROC site, and professor of emergency medicine in the OHSU School of Medicine.
Any community member who does not
want to be included in these, or any future ROC studies that are carried out
without individual prior consent, can obtain a bracelet that opts them out of
all such studies. The bracelet resembles a medical alert bracelet, and
paramedics in the four participating counties are trained to look for them and
exclude any person wearing this bracelet from these studies.
Oregon Health & Science University is the state’s only health and research university, and Oregon’s only academic health center. OHSU is Portland's largest employer and the fourth largest in Oregon (excluding government), with 12,400 employees. OHSU's size contributes to its ability to provide many services and community support activities not found anywhere else in the state. It serves patients from every corner of the state, and is a conduit for learning for more than 3,400 students and trainees. OHSU is the source of more than 200 community outreach programs that bring health and education services to every county in the state.
As a leader in research, OHSU earned $307 million in research funding in fiscal year 2007. OHSU serves as a catalyst for the region's bioscience industry and is an incubator of discovery, averaging one new breakthrough or innovation every three days, with more than 4,100 research projects currently under way. OHSU disclosed 132 inventions in 2007 alone, and OHSU research resulted in 33 new spinoff companies since 2000, most of which are based in Oregon.