Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

Ice water drowning survival of young patient (2025)

jacc.org

Post reply on HN
Print view View original

71–80 of 148 posts

Re: Ice water drowning survival of young patient (2025)

#71

Post by theturtlemoves »

casey2 wrote: post #40
theturtlemoves wrote: post #19

I'd be curious to read about 1, 2, 5, 10, 20 year follow-up. Party pooper warning. I'm afraid I don't have rose tinted glasses, due to personal experience with a family member with TBI (accident at age 16, 3 weeks in a coma). The aftereffects are profoundly destabilizing to his environment. I sometimes have quite a dark view of people's need to be a rescuer and celebrate the "alive!", when they don't have to deal wit…

>40-60 years Oh shut the hell up! We are in the midst of massive technological revolution year on year especially related to biology and brain function. Yes, ALWAYS rescue someone. Treatment progresses it never stops or moves backwards.

> Treatment progresses it never stops or moves backwards.

Unless the episode gets buried at the bottom of the medical file. Unless treatment is "completed" because no more progress can made. Unless insurance doesn't cover it anymore. Unless one bad doctor discourages the patient from ever seeking out another doctor again. Unless the patient himself has only dim awareness, if any, of the fact that this happened and impacts their behavior on a daily basis.

Unless it really can't be fixed, no matter how hard everyone insists that in this day and age it should

Unless they're "Lost to follow-up".

Unless Unless Unless ...

Re: Ice water drowning survival of young patient (2025)

#72

Post by theturtlemoves »

lynx97 wrote: post #69
theturtlemoves wrote: post #19

I'd be curious to read about 1, 2, 5, 10, 20 year follow-up. Party pooper warning. I'm afraid I don't have rose tinted glasses, due to personal experience with a family member with TBI (accident at age 16, 3 weeks in a coma). The aftereffects are profoundly destabilizing to his environment. I sometimes have quite a dark view of people's need to be a rescuer and celebrate the "alive!", when they don't have to deal wit…

> profoundly destabilizing to his environment This is such a dark and dehumanizing take. I am disabled. I definitely had "destabilizing" effects on my environment when I grew up. These days, am as independant as possible. People from your train of thought would have aborted me. Your train of thought leads to what nazi germany already did. Yeah, an extreme example, I know, but following your attitude inevitably leads…

Please don't put words in my mouth

Re: Ice water drowning survival of young patient (2025)

#73

Post by rob74 »

casey2 wrote: post #40
theturtlemoves wrote: post #19

I'd be curious to read about 1, 2, 5, 10, 20 year follow-up. Party pooper warning. I'm afraid I don't have rose tinted glasses, due to personal experience with a family member with TBI (accident at age 16, 3 weeks in a coma). The aftereffects are profoundly destabilizing to his environment. I sometimes have quite a dark view of people's need to be a rescuer and celebrate the "alive!", when they don't have to deal wit…

>40-60 years Oh shut the hell up! We are in the midst of massive technological revolution year on year especially related to biology and brain function. Yes, ALWAYS rescue someone. Treatment progresses it never stops or moves backwards.

If a patient has "sequelae of hypoxic ischemic changes" in their brain like in this case, that means a significant amount of their brain cells have died. The surviving brain cells may or may not be able to take over some of the function of the dead ones, but I'm not aware of any current or future technology that can significantly improve the chances of a positive outcome here.

Then again, I agree with you on principle: if such a patient is brought into the ER, the Hippocratic Oath compels doctors to do everything they can to save them. And since ECMO is widely available (thanks Covid, I guess), they can really do a lot, even if the patient's heart is stopped for extended periods of time. If, like in this case, the patient's heart starts beating again, there's "only" the recovery of brain function to worry about. But there are also patients whose brain is working, but their heart doesn't anymore, so they only live as long as they're connected to the ECMO machine (until they hopefully eventually can get a heart transplant), which presents a whole new set of ethical questions...

Re: Ice water drowning survival of young patient (2025)

#74

Post by lynx97 »

theturtlemoves wrote: post #72
lynx97 wrote: post #69

Earlier quoted context omitted.

> profoundly destabilizing to his environment This is such a dark and dehumanizing take. I am disabled. I definitely had "destabilizing" effects on my environment when I grew up. These days, am as independant as possible. People from your train of thought would have aborted me. Your train of thought leads to what nazi germany already did. Yeah, an extreme example, I know, but following your attitude inevitably leads…

Please don't put words in my mouth

You already put them into your own mouth, maybe wash 'em out if that feels uncomfortable to you.

Re: Ice water drowning survival of young patient (2025)

#75

Post by theturtlemoves »

ikari_pl wrote: post #44
theturtlemoves wrote: post #19

I'd be curious to read about 1, 2, 5, 10, 20 year follow-up. Party pooper warning. I'm afraid I don't have rose tinted glasses, due to personal experience with a family member with TBI (accident at age 16, 3 weeks in a coma). The aftereffects are profoundly destabilizing to his environment. I sometimes have quite a dark view of people's need to be a rescuer and celebrate the "alive!", when they don't have to deal wit…

The paper has the warning phrased differently. "He can at least be an organ donor", basically, in the summary. Your comment and the thread it started helps me a little with dealing with a close person's father's dementia.

I wish you strength in dealing with your situation. Neurological problems are really hard to deal with, especially when you come to realize it really is what it is and have to let go of futile hope.

Re: Ice water drowning survival of young patient (2025)

#76

Post by internet_points »

matsemann wrote: post #57

Something similar happened recently in Norway. A tourist was found severely cold in the mountains, in a storm where extracting him took hours. After a while hypothermia got to him, his heart stopped, and only 8 hours later they got it starting again, was technically dead for 20 hours. In this case, it looks to have gone well with the person afterwards. They say you're not dead until you're warm and dead. News article…

I was also reminded of this :)

Direct link to the write-up of the previous such record: https://www.sciencedirect.com/science/article/abs/pii/S01960...

Re: Ice water drowning survival of young patient (2025)

#77

Post by eru »

vanviegen wrote: post #53
thunfischtoast wrote: post #36

Earlier quoted context omitted.

I feel you, I also unfortunately have experiences with that. It has profoundly changed my view on living, especially how I want to be treated when someday I'm heavily sick. A family member in a coma takes a heavy toll on you, emotionally and financially. They are simultaneously there and not there. If they did not write down how they want to be treated you can never make a decision where you are sure what's right, or…

> For me, the decision is clear: when I'm not able to make my own decisions turn everything off and let me die. And what if you might be able to make decisions again tomorrow. Or the day after? Or in two weeks time.. ? These things are never all that 'clear'.

That's exactly why you write your own decision down, so other people don't have to live with making them for you.

Re: Ice water drowning survival of young patient (2025)

#78

Post by rob74 »

isoprophlex wrote: post #10

"Survival" here being, of course, not a black-and-white thing: > Outcome and Follow-Up > On day 59, the boy was discharged to inpatient neurorehabilitation. At 6-month follow-up, he was giving short commands, standing without support, riding a tricycle, eating soft foods, and relearning simple tasks. Peripheral neuromuscular weakness continued to improve.

Yes, I already feared that when I read "the child recovered" instead of "the child fully recovered" in the summary.

Re: Ice water drowning survival of young patient (2025)

#79

Post by eru »

noduerme wrote: post #24
spacedoutman wrote: post #22

Earlier quoted context omitted.

I have a similar view on general anesthesia now, everyone i know(including myself) that has had operations have been permanently affected by anesthesia. Turning yourself off breaks far more than doctors realize i fear.

I'm not sure what you mean. I've been under general anesthesia a few times and not had any negative consequences. My dad has had multiple brain surgeries, and he's fully functional. Most people I know have been under at least once. I think before you blame anaesthesia it's worth wondering what else happened to you on the table, or whether something else might be causing you the problems. A lot of other things happen…

Well, there's a small chance anesthesia can affect you negatively. Like all medical interventions, it can have side effects.

Re: Ice water drowning survival of young patient (2025)

#80

Post by duskwuff »

wahern wrote: post #21
looofooo0 wrote: post #17

I am sceptical about the 147 minutes, the child could have still clinging onto the ice and just drowned a minute before the parents reached the pond.

It seems below about ~80F you lose consciousness. This kid was nearly half that. Moreover, there have been other similar cases: https://pubmed.ncbi.nlm.nih.gov/32482520/

> It seems below about ~80F you lose consciousness.

Interestingly, the case report notes that "classic cardiac electrical activity" started once the patient reached 82°F.

Post reply on HN