When you run out of air to breathe, apparently the best thing to do is to dip your head in ice cubes and hope that someone comes along and revives you.
Dead' man's recovery shows why prolonged CPR works
Barbara Mantel
NBC News
August 22, 2013
An Ohio man’s recovery several minutes after doctors declared him dead shows how murky the decision can be about when to stop resuscitation efforts.
While Anthony Yahle, 37, may not have been dead for 45 minutes, as was widely reported, his remarkable bounce back without suffering brain damage or other ill effects stunned doctors at Kettering Medical Center in Kettering, Ohio.
Yahle, a diesel mechanic from West Carrollton, Ohio, “coded” -- a term meaning emergency -- on the afternoon of Aug. 5, after arriving in the hospital that morning in cardiac arrest. A team of doctors rushed to his hospital bedside and used chest compressions, a bag connected to a breathing tube and medications to force blood and oxygen through his body. After 45 minutes, they gave up and declared him dead.
“He was truly flatlined at the end of that code. He had no electrical motion, no respiration, and no heart beat, and no blood pressure,” says Jayne Testa, director of cardiovascular services at Kettering.
But five to seven minutes later, the team noticed a trace of electrical activity on his heart monitor and resumed their efforts to resuscitate him. Yahle is now home recovering, according to Testa.
While Yahle "was not dead for 45 minutes," the Kettering doctors “have never seen somebody come back after the code was ended and especially after so many minutes,” says Testa.
Michael Sayre, a professor of emergency medicine at the University of Washington in Seattle and a spokesperson for the American Heart Association, says he has seen and heard of similar cases. It’s unusual but not unique, he says. Sayre doesn’t know what happened in Yahle's case, but sometimes during resuscitation air gets trapped and pressure builds in the lungs, preventing blood from flowing into the heart.
“So, I have seen once or twice where we would disconnect the bag from the breathing tube and push on the chest to let the air out, and then the patient would get a pulse and have a blood pressure because they were able to get blood back to the heart,” says Sayre.
In any case, Sayre says more hospitals may want to follow Kettering’s lead and sustain resuscitation efforts for longer than the typical 20 to 25 minutes. A 2012 nationwide study of hospitals showed that “in the hospitals where they worked for longer, they got more people back, who ended up surviving and going home,” says Sayre.
Technology can help a team decide when to stop. Most hospitals now have the ability to measure the amount of carbon dioxide in the air coming out of the patient. Carbon dioxide is a byproduct of living cells. No carbon dioxide would add to the evidence that the patient is dead. Kettering Medical Center does not continuously measure carbon dioxide levels during resuscitation.
“However, you can be faked out,” says Sayre. And sometimes even with fairly normal carbon dioxide levels, a team will stop resuscitation because “we still cannot get the heart to beat on its own,” says Sayre.
But in Yahle’s case, doctors were finally able to get his heart to beat spontaneously.
“This team did a really good job. They were able to keep his brain alive, and that’s why he survived,” says Sayre.
The Kettering doctors cooled Yahle’s body, and that may have preserved his brain function. “People can definitely go seven minutes without blood flow if the brain is cooled. That is something that is well known,” says Sayre. For example, during brain surgery, doctors cool the body and stop blood flow for even longer periods of time.
There are theories about why that works. “But no one really knows the answer to that,” says Sayre.
Showing posts with label brain damage. Show all posts
Showing posts with label brain damage. Show all posts
Thursday, August 22, 2013
Friday, August 2, 2013
Woman Blames Kaiser for Multi-Organ Failure
Woman Blames Kaiser for Multi-Organ Failure
By BARBARA WALLACE
Courthouse News Service
July 31, 2013
PORTLAND, Ore. (CN) - A Kaiser patient started to bleed internally during an elective surgery to remove a mass from her kidney, and within days she was debilitated due to Kaiser's slow response, she claims in Multnomah County Circuit Court.
Patricia and Joseph Moore sued Northwest Permanente, Kaiser Foundation Hospitals and Kaiser Foundation Healthplan of the Northwest dba Kaiser Permanente for $9.5 million for medical malpractice and loss of consortium.
Within hours of the surgery Moore's abdomen was distended. Other symptoms "consistent with acute hemorrhage" followed, but it was not until shortly after midnight the next day that Kaiser "initiated their rapid transfusion protocol," according to the complaint.
Over the next two days Moore's complications escalated, including falling blood pressure, increasing abdominal distention, rapid heart beat and breathing problems, the complaint says.
"Following numerous transfusions, Patricia Moore sustained respiratory failure and was intubated. During the intubation she aspirated abdominal contents into her airway."
The next morning, "Patricia Moore was diagnosed with acute renal failure," and this was followed by removal of her left kidney and three months on a ventilator, after which she was discharged to a care facility, according to the complaint.
Moore blames Kaiser's failure to timely diagnose and surgically correct the internal bleeding for a host of problems she has experienced, including hemorrhagic shock, multisystem organ failure, acute respiratory failure, gangrene of her left leg and foot, anoxic brain injury and prolonged ventilator dependence.
The plaintiffs are represented by Timothy J. Jones and Ken L. Ammann of Salem, Ore.
By BARBARA WALLACE
Courthouse News Service
July 31, 2013
PORTLAND, Ore. (CN) - A Kaiser patient started to bleed internally during an elective surgery to remove a mass from her kidney, and within days she was debilitated due to Kaiser's slow response, she claims in Multnomah County Circuit Court.
Patricia and Joseph Moore sued Northwest Permanente, Kaiser Foundation Hospitals and Kaiser Foundation Healthplan of the Northwest dba Kaiser Permanente for $9.5 million for medical malpractice and loss of consortium.
Within hours of the surgery Moore's abdomen was distended. Other symptoms "consistent with acute hemorrhage" followed, but it was not until shortly after midnight the next day that Kaiser "initiated their rapid transfusion protocol," according to the complaint.
Over the next two days Moore's complications escalated, including falling blood pressure, increasing abdominal distention, rapid heart beat and breathing problems, the complaint says.
"Following numerous transfusions, Patricia Moore sustained respiratory failure and was intubated. During the intubation she aspirated abdominal contents into her airway."
The next morning, "Patricia Moore was diagnosed with acute renal failure," and this was followed by removal of her left kidney and three months on a ventilator, after which she was discharged to a care facility, according to the complaint.
Moore blames Kaiser's failure to timely diagnose and surgically correct the internal bleeding for a host of problems she has experienced, including hemorrhagic shock, multisystem organ failure, acute respiratory failure, gangrene of her left leg and foot, anoxic brain injury and prolonged ventilator dependence.
The plaintiffs are represented by Timothy J. Jones and Ken L. Ammann of Salem, Ore.
Saturday, May 26, 2012
Brain-Damaged Woman Wins Suit Against City Hospitals
Brain-Damaged Woman Wins Suit Against City Hospitals
By MATT FLEGENHEIMER
New York Times
May 25, 2012
A Bronx jury awarded about $120 million on Friday to a woman who has been incapacitated since she was treated at three local hospitals in 2004.
The award, by a State Supreme Court jury, was made in a lawsuit filed on behalf of Jacqueline Martin, now 45, by her mother. Ms. Martin suffered brain damage after a series of hospital visits in February 2004, the family’s lawyer, Tom Moore, said.
The award is among the largest ever issued for a medical malpractice verdict in the state.
The ruling allocated primary responsibility to two city hospitals: 50 percent to Jacobi Medical Center in the Bronx, and 40 percent to Kings County Hospital Center in Brooklyn. It also allocated 5 percent responsibility to Brookdale University Hospital and Medical Center, and 4 percent to one of its neurologists.
Ms. Martin, who originally sought treatment for a seizure, was found 1 percent responsible. Mr. Moore described that finding as a “quirk” that stemmed from a jury misunderstanding.
The city plans to appeal. In a statement, Suzanne S. Blundi, the deputy counsel for the city’s Health and Hospitals Corporation, expressed sympathy for Ms. Martin’s plight, but said “the amount of this judgment is not consistent with the facts and the law.”
Over the course of less than a month, Mr. Moore said, medical personnel mismanaged Ms. Martin’s medications, failed to respond swiftly to crises and did not provide essential treatments. She developed swelling in her face, eyes and throat in an allergic reaction to anti-seizure medication. She was later diagnosed with Stevens-Johnson syndrome, a rare and severe skin disorder, Mr. Moore said.
The Health and Hospitals Corporation declined to discuss the specifics of Ms. Martin’s medical history, but said that some components of the award appeared excessive. Though Ms. Martin, a mother of two, earned less than $40,000 a year as a claims adjuster, the jury awarded her $10 million in lost earnings. Ms. Martin’s medical costs since 2004, covered by Medicaid, totaled $583,000, the corporation said, but the jury awarded her $5 million for past medical costs.
Mr. Moore acknowledged that “some elements may have been excessive” in that sum of $15 million, but he called the verdict as a whole “totally consistent” with the magnitude of the ordeal.
By MATT FLEGENHEIMER
New York Times
May 25, 2012
A Bronx jury awarded about $120 million on Friday to a woman who has been incapacitated since she was treated at three local hospitals in 2004.
The award, by a State Supreme Court jury, was made in a lawsuit filed on behalf of Jacqueline Martin, now 45, by her mother. Ms. Martin suffered brain damage after a series of hospital visits in February 2004, the family’s lawyer, Tom Moore, said.
The award is among the largest ever issued for a medical malpractice verdict in the state.
The ruling allocated primary responsibility to two city hospitals: 50 percent to Jacobi Medical Center in the Bronx, and 40 percent to Kings County Hospital Center in Brooklyn. It also allocated 5 percent responsibility to Brookdale University Hospital and Medical Center, and 4 percent to one of its neurologists.
Ms. Martin, who originally sought treatment for a seizure, was found 1 percent responsible. Mr. Moore described that finding as a “quirk” that stemmed from a jury misunderstanding.
The city plans to appeal. In a statement, Suzanne S. Blundi, the deputy counsel for the city’s Health and Hospitals Corporation, expressed sympathy for Ms. Martin’s plight, but said “the amount of this judgment is not consistent with the facts and the law.”
Over the course of less than a month, Mr. Moore said, medical personnel mismanaged Ms. Martin’s medications, failed to respond swiftly to crises and did not provide essential treatments. She developed swelling in her face, eyes and throat in an allergic reaction to anti-seizure medication. She was later diagnosed with Stevens-Johnson syndrome, a rare and severe skin disorder, Mr. Moore said.
The Health and Hospitals Corporation declined to discuss the specifics of Ms. Martin’s medical history, but said that some components of the award appeared excessive. Though Ms. Martin, a mother of two, earned less than $40,000 a year as a claims adjuster, the jury awarded her $10 million in lost earnings. Ms. Martin’s medical costs since 2004, covered by Medicaid, totaled $583,000, the corporation said, but the jury awarded her $5 million for past medical costs.
Mr. Moore acknowledged that “some elements may have been excessive” in that sum of $15 million, but he called the verdict as a whole “totally consistent” with the magnitude of the ordeal.
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