31–40 of 81 posts
It's a bit surprising that a 14 year old would ask for alcohol in a country where the drinking age is 18. But hey, it's Italy, perhaps there significantly more relaxed about kids drinking than Americans like me!
There's a reason why they say that "you're not dead until you're warm and dead"! The case of Anna Bågenholm [1] is similarly fascinating. She was in cold meltwater for 80 minutes before being pulled out, and made a ~full recovery. Her core temperature was around 56 degrees when they began resuscitation. It is truly amazing how effective hypothermia is at preserving bodily function! [1] http://en.wikipedia.org/wiki/An…
For the convenience of non-US commenters/readers: that's 13 C.
Earlier quoted context omitted.
Brain death actually occurs at the time of resuscitation. As it wakes individual cells kill themselves as a result of a kind of "self check." If you cool the brain before resuscitation you can hopefully delay the self check to the point where the cells are correctly oxygenated and healthy when it happens. Dying somewhere cold cools your brain, giving you a better chance when you are resuscitated.
That's fascinating, could you point me somewhere I can read more? I'd always assumed something in the cells was decaying without oxygen preventing them from functioning again. Is it some sort of reaction byproduct that normally is part of a chain but the lack of oxygen breaks the chain and makes some other reaction occur?
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It's a kid... you try. Worked a 3 year old a couple weeks ago with an unknown downtime in a pool (up to 15 minutes). He was dead from the outset (initial rhythm was asystole), and he stayed dead (much warmer water in this case), but you still try... This is especially true for cold-water drownings. Downtimes even longer than 42 minutes with full recoveries are not unheard of. You're not dead until you're warm and dea…
I'd hope you'd try for an adult too. But anyway, thank you for your life-saving service.
Some interesting drowning facts: - Clean and cold water is ideal: pneumonia and metabolism. - If you revive a drowned person, insist they go to the hospital: CPR can push the fluid in their lungs into their blood, only to return later on, drowning them all the same, "parking lot drowning." - Quite often, water doesn't enter their lungs as their vocal cords spasm. ~ Paramedic in another life
You mean clean, cold water is ideal for avoiding the bacterial infection (e.g. streptococcus pneumoniae) that causes pneumonia?
Did anyone else catch the doctor mentioning that the boy recently asked for a mojito? It's a bit surprising that a 14 year old would ask for alcohol in a country where the drinking age is 18. But hey, it's Italy, perhaps there significantly more relaxed about kids drinking than Americans like me!
Earlier quoted context omitted.
Brain death actually occurs at the time of resuscitation. As it wakes individual cells kill themselves as a result of a kind of "self check." If you cool the brain before resuscitation you can hopefully delay the self check to the point where the cells are correctly oxygenated and healthy when it happens. Dying somewhere cold cools your brain, giving you a better chance when you are resuscitated.
That's fascinating, could you point me somewhere I can read more? I'd always assumed something in the cells was decaying without oxygen preventing them from functioning again. Is it some sort of reaction byproduct that normally is part of a chain but the lack of oxygen breaks the chain and makes some other reaction occur?
Did anyone else catch the doctor mentioning that the boy recently asked for a mojito? It's a bit surprising that a 14 year old would ask for alcohol in a country where the drinking age is 18. But hey, it's Italy, perhaps there significantly more relaxed about kids drinking than Americans like me!
Alcohol isn't a social problem and it's tolerated for young people to drink (or to smoke weed) despite not being yet 18 - at least in Milan.
Earlier quoted context omitted.
I'd hope you'd try for an adult too. But anyway, thank you for your life-saving service.
The window for 'trying' is longer for kids (that's based on more than just emotion though... kids are a lot more resilient).
Earlier quoted context omitted.
The window for 'trying' is longer for kids (that's based on more than just emotion though... kids are a lot more resilient).
Don't you have protocols for this? Is it entirely up to individual preparation for how long (and how) you 'try'?
If there is no electrical activity, then we'll go through a couple 'rounds' of ACLS, and it there is no response, we'll just pronounce them. Very rarely do we transport an adult in cardiac arrest. CPR in a moving ambulance is very difficult to perform adequately, and in most cases we would just be bringing them to a facility that would be providing the same level of care that we are in the field (albeit with more hands available to help, but the tradeoff in time and poor quality CPR isn't worth it).
The only exception to this are cases of traumatic arrests. If something is physically broken, no amount of CPR, drugs, or electricity are going to help, and their only hope is bright lights and cold steel (in a surgeon's hand). Needless to say, the survival rates for out of hospital traumatic arrests are _vanishingly_ small.
Kids are different though... They're easier to move, and easier to do CPR on. This means in most cases a pediatric arrest is a 'scoop and run', with any interventions being performed on the way in. This is in part because the resiliency of kids means they are a _little_ more tolerant of the time, and scene's with dead kids tend to be extremely chaotic. It can be very difficult to concentrate with an (understandably) distraught parent yelling at you.
[1] https://en.wikipedia.org/wiki/Advanced_cardiac_life_support [2] https://en.wikipedia.org/wiki/Pediatric_advanced_life_suppor...