Dying, Reanimation and Medicine
There is a phrase – “The golden hour” used in Medicine:
In emergency medicine the golden hour is the first sixty minutes after the occurrence of multi-system trauma. It is widely believed that the victim’s chances of survival are greatest if he receives definitive care in the operating room within the first hour. Recent scrutiny, however, calls this assertion into question.(Golden Hour, Wikipedia)
I originally stumbled across this terminology in some Wired Military Blogs, and scratched out a few ideas in Military has Augmented Grunts but Swamped and Uninformed Agents? Some scientist in Be more than you can be @ Wired, is researching to extend this golden hour:
Animals need oxygen. But some creatures, like nematodes, fruit flies, and zebra fish, don’t die if oxygen levels drop. Instead the critters suspend. Their hearts stop beating for up to 24 hours. They don’t breathe. And they don’t die. Wounds stop bleeding; nearly any injury becomes survivable, and the brain shuts down without damage. “If you were shot, this is exactly what you would want,†Roth says.
It’s a timing issue: At oxygen concentrations below some critical level, animals kick off. But take the oxygen level even lower than that, fast, and they don’t. The problem was, Roth couldn’t figure out how to pull off his oxygen reduction trick in mammals, let alone humans. What would a battlefield medic do? Tie a plastic bag over a wounded soldier’s head?
A television show gave Roth the clue he needed. In October 2002, he was watching a PBS show about caving in Mexico. The host had to don a breathing mask because the cavern’s air was full of hydrogen sulfide, which binds to mitochondria and impedes the body’s ability to use oxygen.
I don’t know much about medicine, and I’m not going to pretend that I do. This Mitochondria thing seems to be important though.
To Treat the Dead @ MSNBC talks about people having heart attacks, and questions what actually makes people die. They are looking at heart attack scenarios where someone is dead, but when they get to hospital they are pumped with oxygen and jolted back to life.
The new science of resuscitation is changing the way doctors think about heart attacks—and death itself. … The research takes them deep into the machinery of the cell, to the tiny membrane-enclosed structures known as mitochondria where cellular fuel is oxidized to provide energy. Mitochondria control the process known as apoptosis, the programmed death of abnormal cells that is the body’s primary defense against cancer. “It looks to us,” says Becker, “as if the cellular surveillance mechanism cannot tell the difference between a cancer cell and a cell being reperfused with oxygen. Something throws the switch that makes the cell die.”
With this realization came another: that standard emergency-room procedure has it exactly backward.
(Found this via JWZ Livejournal – Docs Change the Way They Think About Death)
So, the last article talks about cells only starting to die after an hour or so without oxygen. This in itself blows away some concepts I had about cell decay, but who really knows and is it consistent, or temperature related (e.g. heart attack in the hot sun)
It does make you wonder what we will think of current medical practices in 20 years. One of the comments on JWZ mentions the old practice of using leeches in medicine, which is now defunct. But at the time that would have seemed conventional wisdom.
It raises questions about what does dead mean?
If you can induce this hibernation state in people (like for card accidents, gun shots etc) what does that mean for the future of surviving injuries?