Modern technology has affected our lives in all aspects from social networking to consumer spending, to Medicine. The recent advents of medical research and development have helped to save countless lives, many would call these life saving events a miracle, others would call it unethical. Today we will look at both sides and discuss the technology behind
Therapeutic Hypothermia.
Therapeutic Hypothermia is a procedure in which following what would normally be a potentially fatal dysrythmia (irregular heartbeat) the patient is medically cooled to a temperature in which the bodies detrimental processes are suspended. By doing this, those detrimental processes are stalled long enough to be treated by Doctors and lessen the impact that those processes have on the organs and the body.
Several patients have already been given a
new lease on life following this treatment. The American Heart Association adopted this procedure in 2005, since then the statistics have been overwhelming.
As you can see from the above chart, published by the
American Heart Association, the results are amazing. However, amazing the results are, there are still some basic assumptions that must be addressed.
First, does the person being saved at this extra expense, process, procedure, whatever you want to call it, want to be saved? Dependent upon their age, medical condition, or point in life they may not wish to prolong the inevitable. Perhaps they have another terminal disease process and have finally come to terms with their fate. Second, does their religion allow for such radical procedures to be done? Third, is there chance that after the procedure is done they may live, but have some drastic deficits which would leave them crippled or disabled for the rest of there new found life?
Not only are the above questions assumptions that must be addressed but they are also questions that are raised in
opposition of this procedure. You’ll notice in the included link that there is also discussion on this procedures use in pediatric patients with debilitating brain disorders. What is the extended outlook for these patients? Currently we are only 5 years into this new procedure being used on humans. When we address the above mentioned questions there are procedures in place to avoid these problems.
Those patients who have reached a point in their life where they have made a decision about what they want done in the event of their life's end, can file a living Will or a Advanced Directives order known as a DNR (Do Not Resuscitate) which is signed by their Doctor and states what advanced procedures if any they want done when the time comes. However, when Paramedics arrive at their side when they have the “big one” the document must be clearly posted so that they may find it, or they must have the document on them at all times and the Medics must know about this documents existence on the person. Due to legal ramifications, if the document is not signed or presented to the Paramedics they will proceed with life saving interventions despite whatever bystander or relative may voice in opposition. Then you have potentially saved a person who did not want to be saved.
When it comes to Religious beliefs we have to look at all Religions and whether we have to look at what the patients beliefs would have wanted or allowed. There are several articles available online that show how
extreme Religion may play a part in peoples lives.
The final argument that we will discuss is the possible long term effects that this procedure may have on the body. When someone goes into cardiac arrest their heart is not properly
perfusing the rest of the body, more importantly the brain. The brain requires oxygen to live which is transported via the blood stream, when the heart fails the brain starves. The brain cells will start to die within four to six minutes after deprivation of oxygen. The average response time goal for First responders is four minutes. Then they start their interventions, CPR,CCR, etc., and this is assuming that there were no delays due to traffic or any other problems during their response. For the patients that are alone when they go into cardiac arrest we would have little idea of how long they have been down, there are of course ways that the hospital can check for brain activity but how much is enough? When do we decide that this person should have another go at life with their current health?
These are all valid concerns, however being as I am in the medical profession I have seen the results of therapeutic hypothermia first hand, and I’m all for it. It works! Along with the new advances in CCR (Cardio Cerebral Resuscitation) and the
publics awareness of CPR, lives are being saved. When you educate the public we have someone there before first responders to start circulating that oxygen rich blood which is still in the patients vascular system. They provide the pump, then when the first responders arrive they start working a viable patient.
In my opinion the risk of offending someone's final wishes when there is no one there to speak for them is worth it, if I don’t see or cannot be given proof of Advanced Directives or a valid DNR, I am not going to postpone life saving procedures.
In closing I would like to invite all who are interested to the
CPR Across America training at Tims Toyota Center on October 25th there will be food and drinks and you will be a learning the tools needed to save a life, free!