Emergency Preservation and Resuscitation
Emergency Preservation and Resuscitation (EPR) is an experimental medical procedure developed to rapidly preserve the organism during ischemia, using hypothermia, drugs, and fluids, to “buy time” for transport and resuscitative surgery. Trials are being done to test the feasibility of rapidly inducing profound hypothermia (< 10oC) with an aortic flush in trauma victims that have suffered CA and failed standard resuscitative efforts to enable resuscitative surgery and delayed resuscitation with cardiopulmonary bypass. The primary outcome variable will be survival to hospital discharge with minimal neurologic dysfunction.
Theory
When a cardiac arrest patients arrives at emergency rooms with gunshot or stab wounds die, doctors have mere minutes to open the patient's chest and get the heart pumping again. As of 2015, about 95% of such patients die. EPR is an experimental technique to attempt to improve those odds of survival, by dropping the patient's temperature and giving the doctor more time to find and stop the source of the bleeding before the patient dies.[1]
Practice
As of 2015, Samuel Tisherman and researchers at the University of Maryland's Shock Trauma Center were hoping to obtain regulatory approval to begin enrolling patients in the study by the end of the year. Regulatory approval is complicated by the fact that victims of trauma and cardiac arrest are incapacitated and therefore unable to personally consent to experimental treatment; therefore more stringent "community consent" guidelines must be fulfilled in order to gain approval for the experimental EPR operation.[1]