Bureaucracy is apparently not pro-life

[brynndragon]

First, learn how an incredibly simple piece of organizational tech (so simple I hesitate to use the word "tech") means ICU staff spend less money to save more lives: The Checklist

Then, learn how the government decided we certainly can't let something this useful continue: A Lifesaving Checklist

Look, I'm a huge fan of ethics in research. I wish examining ethical issues with scientific research was a requirement for all science undergrads. But holding this research to the exact same standards as experimental drugs is a terrible mistake. We do need to be hella careful when dealing with the sickest of the sick, but you can take it too far and it looks like OHRP has. How many people will die of preventable infections before they figure out the standards this sort of research will require to satisfy Confucius' bastard child, bureaucracy?

Comments

Re: Quis custodiet ipsos custodies?

[c1.livejournal.com]

I think the big issue I have with checklists (and I'm not saying I don't like to use them,) is flexibility to do something new.

I first learned of the value of compressions over ventilations in CPR at a conference, almost a year before the AHA released the new guidelines that call for a ratio of 30:2 instead of the well-known 5:1. (In a nutshell, the heart likes to keep going, and we use far less oxygen than 5:1 offers.) Were I still practicing, that knowledge might have made it to my patients. (I *really* hope it's a cold day in hell when they introduce checklists to CPR-- there really aren't a whole lot of steps, and if nothing else, time is of the essence in a serious way.)

On the flip side, there's checklists (in the prehospital setting) for stroke/STEMI, administering epi-pens, and a few other procedures, and I think in that arena, they make a lot of sense.

Re: Quis custodiet ipsos custodies?

[benndragon.livejournal.com]

Oh, I thought it was clear that the checklists were for procedures that have a lot of prep steps, such as putting in lines or putting a patient on a respirator, or things like making sure you've checked to see if the patient needs pain meds now, or things like making sure the hospital is ready to give a patient what they are going to need once they get in (like the Austrian girl, or "gunshot wound to $body_area", etc). After all, checklists don't tell pilots how to fly, they just make sure they don't forget something bloody obvious that they do every single day.