Tuesday, June 12, 2012

Our friendly neighborhood trauma-surgery notice

Odd notice on the wall in Civic Center Station downtown. Anyone know context for this?

Web sites about it, per the poster itself, here and here. It looks like there's more detail about this "PROPPR" study here.

Looks like it's saying that if you get carried into San Francisco General Hospital unconscious and bleeding massively, they might choose the mix of blood products for your transfusion in a way that advances a medical study, and worry later about getting your consent or the consent of someone acting for you. Which might be fine because "Both ratios [of blood products] are in widespread clinical use in the United States." I'm no medical expert. It might all be fine. Just, odd. Never seen anything like this in a subway station.

Here's the poster (click to enlarge).

Also, whose idea was it to post the sign here in particular? Does someone think that if we're likely to be brought in bleeding from massive trauma, we're likely to start at Civic Center Station? That's kind of an honor in the very oddest of ways. But, still, it's odd.

1 comment:

  1. Emergency Medicine research is extremely difficult to do with consent because no one schedules their accidents, and they are usually unable to provide consent at the time of injury.

    Because of this, the FDA has created a special and rare classification called "Exception From Informed Consent." It's highly regulated and rarely approved.

    This research randomizes each patient to one of two treatments. These treatments are both standards of care (depending on location), but neither treatment has ever been proven to be better than the other. This research aims to settle the debate.

    Since no consent is obtained prior to enrolling these critically ill trauma patients, the FDA requires study sites to engage in "Public Disclosure" and "Community Consultation." This means that each study site has to develop a good-faith plan to notify their community. This involves speaking at churches, and clubs, creating a website, and posting signs in subways if need be. This gives people an early option to "opt out" by wearing an armband or entering their data into an "opt out" online database.

    It's impossible to notify all of a community, or even a majority, but that is why you saw this sign.

    Truth be known...patient's who end up enrolled in these kind of trials usually get better care than those who don't.