Many moons ago an associate was part of a landmark study for a medication I guarantee is now on your rig. You probably gave some today.
In the course of this study, Paramedic crews who encountered the specific condition that warranted the specific intervention were entered as candidates in the study with family consent. Most times, I’ve learned, people want something new to be used if it will help. After all, “…if it didn’t help, why would they be testing it?” I’ve heard a few times.
The way to keep it double blind was to give two doses from the same kit, only the researchers after the fact knowing which was medicine and which not.
However, to get permission to deviate from established protocols, we had to get Base Physician approval to administer the study kit.
When you called on the radio you would give the information that met criteria for the study. If it seemed, in the MDs eyes, that your patient needed quicker interventions the study was put aside and normal actions taken. In the kit are a number of colored packets with different concentrations, dosages, who knows, but each kit is to be chosen by a pre-determined list at the hospital.
The MD on the other end of the line will check the list and order you to give a certain colored kit to the patient, possibly based on information from the report, time of day, who knows.
Imagine this scenario:
You are dispatched to the home of an African-American family who’s mother is experiencing [Study specific medical condition]. The family is adamant that you help and you assure them everything is being done. Your EMT is like lightening to the [BLS intervention for study specific medical condition] and you radio to Base for permission to enroll in the study.
After all the info is exchanged, the MD comes back over the radio on your lapel stating:
“Copy that Medic 99 your patient is a candidate. Open and administer the…the…BLACK drug, copy?”
The family erupts!
“No! Give her the white drug! She wants the white drug!”
After an explanation of the situation and showing the multiple colored kits the family calms down and mom recovers from the [study specific medical condition].
Keep in mind that even though you think things you say or do are harmless, your patients and their families may misunderstand. Be ready for a quick explanation.
But that led me to wonder…who gets this rainbow colored one?