Philadelphia takes on gun violence with altered emergency care approach

In the modern era of population health-focused care, gun violence is a problem hospitals must address, and now Philadelphia hospitals are testing an unconventional approach to the problem, according to STAT News: doing less to treat patients with gunshot wounds.

It’s an experiment that will incorporate the city’s population at large, particularly the residents of high-risk neighborhoods. Under the strategy, paramedics will alter their emergency trauma response for random patients, forgoing intubation and intravenous fluid administration. While both steps are part of the typical emergency care response to stabbing or gunshot wounds, the study’s architects say these steps do more harm than good by risking increased blood pressure, which can prove fatal. Temple University Hospital Chief of Surgery Amy Goldberg, M.D., will head the study.

The City of Brotherly Love saw more than 1,200 shootings and 236 homicides last year, with the violence disproportionately affecting young black men. The Food and Drug Administration will waive its informed-consent rules for the subjects, as there is no reliable way of seeking informed permission from gravely wounded patients. 

The study will begin in fall and last for either the next five years or until doctors have treated 1,000 patients, according to the article. Patients who don’t wish to participate can obtain a wristband indicating they want traditional trauma care. Already, the proposal is attracting some controversy among the populations it will affect, especially as it will involve a largely white team and heavily black and Latino populations.

“You’re using people to do this study,” Charles Lanier, head of a neighborhood revitalization group, told STAT News. “I hear what you’re saying, but in the interim, you’re still sacrificing somebody to prove which [method] is better.”

- here’s the article