This summer I had the opportunity to participate in a research project at the Medical College of Wisconsin. The project that I worked on was called the Hypertonic Saline Study (HSS). It is part of the Resuscitation Outcomes Consortium. (NIH News: New Federally Funded Research Program Aims to Improve Survival from Cardiac Arrest and Severe Trauma) The Medical College of Wisconsin and Froedtert is one of many sites throughout the United States and Canada that is participating.

The HSS looks at how pre-hospital interventions improve outcome and quality of life for trauma victims. The most common trauma that I saw were gunshots or motor vehicle crashes. (FYI, “crashes” is preferred over accidents because accidents imply that there in no fault.) Paramedics would give study solution to trauma victims with either a systolic BP < = 70 and/or a GCS <= 8. I won't go into the other exclusion criteria. The study solutions could be either normal saline, hypertonic saline, or hypertonic saline plus dextran. Hypertonic just means that the saline had a higher concentration of salt. The paramedics gave this fluid (250cc) intravenously in order to try and restore blood pressure and prevent shock. The general idea behind the added salt is that it helps the body hold onto water and maintain blood pressure. We were blinded to the type of IV fluid administered.

The experimental treatment side of the study ended after the 250cc fluid was given. My job as a student researcher was to follow up on these patients as they entered the various ICUs and the step down floors. This involved data collection from patients' charts and interaction with the patients to see how they were doing. Probably the most important thing that I did was to inform patients and families of the experiment that they had been enrolled in. Due to the emergency nature of this study, the FDA allows us to administer the study solution without informed consent (or under exception to informed consent). (IV saline is a standard of procedure that is necessary to restore blood pressure in order to help these trauma victims survive. Previous research has showed that the study solutions that might be given in leu of normal saline are believed to be better than normal saline. So, regardless of the type of saline that the patient was given, he received at least the current standard of care.) Most patients were very happy to continue participating (meaning that we are then able to continue to collect their hospital stay data) and glad to know that information that they provide may one day be used to create a new standard of care with one of the experimental fluids.

All in all, this was a great experience. Unlike some students whose research involved a lot of chart review, my day involved rounding on patients. Since I would rather be walking around and interacting with people, this suited me just fine. I also gained an appreciation for the emergency medicine system, the doctors/nurses/staff that work on it, and the layout of the hospital. I know I won’t feel lost the first time I’m on 3rd year rotations trying to find the SICU.