{"id":731,"date":"2015-05-05T20:49:55","date_gmt":"2015-05-05T19:49:55","guid":{"rendered":"https:\/\/blogs.bmj.com\/adc\/?p=731"},"modified":"2015-05-01T23:07:50","modified_gmt":"2015-05-01T22:07:50","slug":"critical-interventions","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/adc\/2015\/05\/05\/critical-interventions\/","title":{"rendered":"Critical interventions"},"content":{"rendered":"

\"\"There are considerable numbers of interventions which are undertaken at points of emergency; severe head injury, severe septic shock, myocardial infarction, admissions to intensive care units… In these situations it can be extremely tricky to\u00a0get the critically ill, often unconscious, individual to agree to being randomised in a clinical trial. Yet without that, we won’t know what treatment to give. Or not give.<\/p>\n

But surely we should just use common sense?<\/p>\n

Like oxygen for myocardial infarction<\/a>?<\/p>\n

Or can we undertake “deferred consent” – a rather odd phrase which means seeking consent for the data collected after<\/strong> a patient has been, because of a critical care emergency, entered into a randomised trial.\u00a0<\/p>\n

Woah!<\/p>\n

I can hear the gasps of disbelief from here, despite not having any form of audio connection to your laptop. (No honestly, you don’t need to put the colander back on. I really really can’t hear anything. It’s a figure of speech.)<\/p>\n

Not only can this be done, and is legal in the UK and many other places, but there’s some wonderful research <\/a>been undertake on this looking at the views of parents whose children took part in such trials. The bottom line is, that while there is some individual variation, the large majority of parents were happy for their children to have been entered into such studies. And more than that, the @CONNECTstudy<\/a>\u00a0have gone even further and come up with guidelines for researchers: tinyurl.com\/CONNECTguideline<\/a><\/p>\n

The challenge, it seems, is\u00a0working out how to get on the ground practitioners to believe in research and act on it. Surely it’s not that difficult? After all, mag-sulf antenatally protects neonatal brains and that’s widely used .. isn’t it<\/a>?<\/p>\n

– Archi<\/p>\n

@ADC_BMJ<\/p>\n

 <\/p>\n","protected":false},"excerpt":{"rendered":"

There are considerable numbers of interventions which are undertaken at points of emergency; severe head injury, severe septic shock, myocardial infarction, admissions to intensive care units… In these situations it can be extremely tricky to\u00a0get the critically ill, often unconscious, individual to agree to being randomised in a clinical trial. Yet without that, we won’t […]<\/p>\n

Read More…<\/a><\/p>\n","protected":false},"author":7,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[79],"tags":[],"class_list":["post-731","post","type-post","status-publish","format-standard","hentry","category-archimedes"],"yoast_head":"\nCritical interventions - ADC Online Blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/adc\/2015\/05\/05\/critical-interventions\/\" \/>\n<meta property=\"og:locale\" content=\"en_GB\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Critical interventions - ADC Online Blog\" \/>\n<meta property=\"og:description\" content=\"There are considerable numbers of interventions which are undertaken at points of emergency; severe head injury, severe septic shock, myocardial infarction, admissions to intensive care units… In these situations it can be extremely tricky to\u00a0get the critically ill, often unconscious, individual to agree to being randomised in a clinical trial. Yet without that, we won’t [...]Read More...\" \/>\n<meta property=\"og:url\" content=\"https:\/\/blogs.bmj.com\/adc\/2015\/05\/05\/critical-interventions\/\" \/>\n<meta property=\"og:site_name\" content=\"ADC Online Blog\" \/>\n<meta property=\"article:published_time\" content=\"2015-05-05T19:49:55+00:00\" \/>\n<meta property=\"og:image\" content=\"http:\/\/www.cts.usc.edu\/graphics\/pg_19107970s.jpg\" \/>\n<meta name=\"author\" content=\"Bob Phillips\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Bob Phillips\" \/>\n\t<meta name=\"twitter:label2\" content=\"Estimated reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"1 minute\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/adc\\\/2015\\\/05\\\/05\\\/critical-interventions\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/adc\\\/2015\\\/05\\\/05\\\/critical-interventions\\\/\"},\"author\":{\"name\":\"Bob Phillips\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/adc\\\/#\\\/schema\\\/person\\\/9e94029681ecf36e73bbd1eb2be2ef94\"},\"headline\":\"Critical interventions\",\"datePublished\":\"2015-05-05T19:49:55+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/adc\\\/2015\\\/05\\\/05\\\/critical-interventions\\\/\"},\"wordCount\":296,\"commentCount\":0,\"publisher\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/adc\\\/#organization\"},\"image\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/adc\\\/2015\\\/05\\\/05\\\/critical-interventions\\\/#primaryimage\"},\"thumbnailUrl\":\"http:\\\/\\\/www.cts.usc.edu\\\/graphics\\\/pg_19107970s.jpg\",\"articleSection\":[\"archimedes\"],\"inLanguage\":\"en-GB\",\"potentialAction\":[{\"@type\":\"CommentAction\",\"name\":\"Comment\",\"target\":[\"https:\\\/\\\/blogs.bmj.com\\\/adc\\\/2015\\\/05\\\/05\\\/critical-interventions\\\/#respond\"]}]},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/adc\\\/2015\\\/05\\\/05\\\/critical-interventions\\\/\",\"url\":\"https:\\\/\\\/blogs.bmj.com\\\/adc\\\/2015\\\/05\\\/05\\\/critical-interventions\\\/\",\"name\":\"Critical interventions - ADC Online Blog\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/adc\\\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/adc\\\/2015\\\/05\\\/05\\\/critical-interventions\\\/#primaryimage\"},\"image\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/adc\\\/2015\\\/05\\\/05\\\/critical-interventions\\\/#primaryimage\"},\"thumbnailUrl\":\"http:\\\/\\\/www.cts.usc.edu\\\/graphics\\\/pg_19107970s.jpg\",\"datePublished\":\"2015-05-05T19:49:55+00:00\",\"breadcrumb\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/adc\\\/2015\\\/05\\\/05\\\/critical-interventions\\\/#breadcrumb\"},\"inLanguage\":\"en-GB\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/blogs.bmj.com\\\/adc\\\/2015\\\/05\\\/05\\\/critical-interventions\\\/\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"en-GB\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/adc\\\/2015\\\/05\\\/05\\\/critical-interventions\\\/#primaryimage\",\"url\":\"http:\\\/\\\/www.cts.usc.edu\\\/graphics\\\/pg_19107970s.jpg\",\"contentUrl\":\"http:\\\/\\\/www.cts.usc.edu\\\/graphics\\\/pg_19107970s.jpg\"},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/adc\\\/2015\\\/05\\\/05\\\/critical-interventions\\\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\\\/\\\/blogs.bmj.com\\\/adc\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Critical interventions\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/adc\\\/#website\",\"url\":\"https:\\\/\\\/blogs.bmj.com\\\/adc\\\/\",\"name\":\"ADC Online Blog\",\"description\":\"Education, debate, and meandering thoughts on child health, using evidence and research.\",\"publisher\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/adc\\\/#organization\"},\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\\\/\\\/blogs.bmj.com\\\/adc\\\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"en-GB\"},{\"@type\":\"Organization\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/adc\\\/#organization\",\"name\":\"ADC Online Blog\",\"url\":\"https:\\\/\\\/blogs.bmj.com\\\/adc\\\/\",\"logo\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-GB\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/adc\\\/#\\\/schema\\\/logo\\\/image\\\/\",\"url\":\"https:\\\/\\\/blogs.bmj.com\\\/adc\\\/files\\\/2017\\\/10\\\/blog-logo-adc.png\",\"contentUrl\":\"https:\\\/\\\/blogs.bmj.com\\\/adc\\\/files\\\/2017\\\/10\\\/blog-logo-adc.png\",\"width\":285,\"height\":34,\"caption\":\"ADC Online Blog\"},\"image\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/adc\\\/#\\\/schema\\\/logo\\\/image\\\/\"}},{\"@type\":\"Person\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/adc\\\/#\\\/schema\\\/person\\\/9e94029681ecf36e73bbd1eb2be2ef94\",\"name\":\"Bob Phillips\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-GB\",\"@id\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/9ce6165c429dd8d36e6532db799ebe58e6f9c614c44e05e60d553e4bac662441?s=96&d=mm&r=g\",\"url\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/9ce6165c429dd8d36e6532db799ebe58e6f9c614c44e05e60d553e4bac662441?s=96&d=mm&r=g\",\"contentUrl\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/9ce6165c429dd8d36e6532db799ebe58e6f9c614c44e05e60d553e4bac662441?s=96&d=mm&r=g\",\"caption\":\"Bob Phillips\"},\"url\":\"https:\\\/\\\/blogs.bmj.com\\\/adc\\\/author\\\/bphillips\\\/\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Critical interventions - ADC Online Blog","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/blogs.bmj.com\/adc\/2015\/05\/05\/critical-interventions\/","og_locale":"en_GB","og_type":"article","og_title":"Critical interventions - ADC Online Blog","og_description":"There are considerable numbers of interventions which are undertaken at points of emergency; severe head injury, severe septic shock, myocardial infarction, admissions to intensive care units… In these situations it can be extremely tricky to\u00a0get the critically ill, often unconscious, individual to agree to being randomised in a clinical trial. Yet without that, we won’t [...]Read More...","og_url":"https:\/\/blogs.bmj.com\/adc\/2015\/05\/05\/critical-interventions\/","og_site_name":"ADC Online Blog","article_published_time":"2015-05-05T19:49:55+00:00","og_image":[{"url":"http:\/\/www.cts.usc.edu\/graphics\/pg_19107970s.jpg","type":"","width":"","height":""}],"author":"Bob Phillips","twitter_card":"summary_large_image","twitter_misc":{"Written by":"Bob Phillips","Estimated reading time":"1 minute"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"Article","@id":"https:\/\/blogs.bmj.com\/adc\/2015\/05\/05\/critical-interventions\/#article","isPartOf":{"@id":"https:\/\/blogs.bmj.com\/adc\/2015\/05\/05\/critical-interventions\/"},"author":{"name":"Bob Phillips","@id":"https:\/\/blogs.bmj.com\/adc\/#\/schema\/person\/9e94029681ecf36e73bbd1eb2be2ef94"},"headline":"Critical interventions","datePublished":"2015-05-05T19:49:55+00:00","mainEntityOfPage":{"@id":"https:\/\/blogs.bmj.com\/adc\/2015\/05\/05\/critical-interventions\/"},"wordCount":296,"commentCount":0,"publisher":{"@id":"https:\/\/blogs.bmj.com\/adc\/#organization"},"image":{"@id":"https:\/\/blogs.bmj.com\/adc\/2015\/05\/05\/critical-interventions\/#primaryimage"},"thumbnailUrl":"http:\/\/www.cts.usc.edu\/graphics\/pg_19107970s.jpg","articleSection":["archimedes"],"inLanguage":"en-GB","potentialAction":[{"@type":"CommentAction","name":"Comment","target":["https:\/\/blogs.bmj.com\/adc\/2015\/05\/05\/critical-interventions\/#respond"]}]},{"@type":"WebPage","@id":"https:\/\/blogs.bmj.com\/adc\/2015\/05\/05\/critical-interventions\/","url":"https:\/\/blogs.bmj.com\/adc\/2015\/05\/05\/critical-interventions\/","name":"Critical interventions - ADC Online Blog","isPartOf":{"@id":"https:\/\/blogs.bmj.com\/adc\/#website"},"primaryImageOfPage":{"@id":"https:\/\/blogs.bmj.com\/adc\/2015\/05\/05\/critical-interventions\/#primaryimage"},"image":{"@id":"https:\/\/blogs.bmj.com\/adc\/2015\/05\/05\/critical-interventions\/#primaryimage"},"thumbnailUrl":"http:\/\/www.cts.usc.edu\/graphics\/pg_19107970s.jpg","datePublished":"2015-05-05T19:49:55+00:00","breadcrumb":{"@id":"https:\/\/blogs.bmj.com\/adc\/2015\/05\/05\/critical-interventions\/#breadcrumb"},"inLanguage":"en-GB","potentialAction":[{"@type":"ReadAction","target":["https:\/\/blogs.bmj.com\/adc\/2015\/05\/05\/critical-interventions\/"]}]},{"@type":"ImageObject","inLanguage":"en-GB","@id":"https:\/\/blogs.bmj.com\/adc\/2015\/05\/05\/critical-interventions\/#primaryimage","url":"http:\/\/www.cts.usc.edu\/graphics\/pg_19107970s.jpg","contentUrl":"http:\/\/www.cts.usc.edu\/graphics\/pg_19107970s.jpg"},{"@type":"BreadcrumbList","@id":"https:\/\/blogs.bmj.com\/adc\/2015\/05\/05\/critical-interventions\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/blogs.bmj.com\/adc\/"},{"@type":"ListItem","position":2,"name":"Critical interventions"}]},{"@type":"WebSite","@id":"https:\/\/blogs.bmj.com\/adc\/#website","url":"https:\/\/blogs.bmj.com\/adc\/","name":"ADC Online Blog","description":"Education, debate, and meandering thoughts on child health, using evidence and research.","publisher":{"@id":"https:\/\/blogs.bmj.com\/adc\/#organization"},"potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/blogs.bmj.com\/adc\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"en-GB"},{"@type":"Organization","@id":"https:\/\/blogs.bmj.com\/adc\/#organization","name":"ADC Online Blog","url":"https:\/\/blogs.bmj.com\/adc\/","logo":{"@type":"ImageObject","inLanguage":"en-GB","@id":"https:\/\/blogs.bmj.com\/adc\/#\/schema\/logo\/image\/","url":"https:\/\/blogs.bmj.com\/adc\/files\/2017\/10\/blog-logo-adc.png","contentUrl":"https:\/\/blogs.bmj.com\/adc\/files\/2017\/10\/blog-logo-adc.png","width":285,"height":34,"caption":"ADC Online Blog"},"image":{"@id":"https:\/\/blogs.bmj.com\/adc\/#\/schema\/logo\/image\/"}},{"@type":"Person","@id":"https:\/\/blogs.bmj.com\/adc\/#\/schema\/person\/9e94029681ecf36e73bbd1eb2be2ef94","name":"Bob Phillips","image":{"@type":"ImageObject","inLanguage":"en-GB","@id":"https:\/\/secure.gravatar.com\/avatar\/9ce6165c429dd8d36e6532db799ebe58e6f9c614c44e05e60d553e4bac662441?s=96&d=mm&r=g","url":"https:\/\/secure.gravatar.com\/avatar\/9ce6165c429dd8d36e6532db799ebe58e6f9c614c44e05e60d553e4bac662441?s=96&d=mm&r=g","contentUrl":"https:\/\/secure.gravatar.com\/avatar\/9ce6165c429dd8d36e6532db799ebe58e6f9c614c44e05e60d553e4bac662441?s=96&d=mm&r=g","caption":"Bob Phillips"},"url":"https:\/\/blogs.bmj.com\/adc\/author\/bphillips\/"}]}},"_links":{"self":[{"href":"https:\/\/blogs.bmj.com\/adc\/wp-json\/wp\/v2\/posts\/731","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.bmj.com\/adc\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.bmj.com\/adc\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.bmj.com\/adc\/wp-json\/wp\/v2\/users\/7"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.bmj.com\/adc\/wp-json\/wp\/v2\/comments?post=731"}],"version-history":[{"count":0,"href":"https:\/\/blogs.bmj.com\/adc\/wp-json\/wp\/v2\/posts\/731\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.bmj.com\/adc\/wp-json\/wp\/v2\/media?parent=731"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.bmj.com\/adc\/wp-json\/wp\/v2\/categories?post=731"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.bmj.com\/adc\/wp-json\/wp\/v2\/tags?post=731"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}