Posted on 02/01/2015 2:33:42 PM PST by Morgana
Do you know how Jahi is doing so far? Brain dead people don’t usually start menses a year after they “died”.
There are biases in this article that make me doubt its accuracy.
First, an apnea test is neither dangerous nor does it induce brain death. Simply put, you give oxygen but no ventilator assistance and check for spontaneous breathing over a few minutes. You look for any sign of breathing AND you check CO2 status. Your breathing is driven by CO2. I’ll show you: hold your breath and count as long as you can. Now, hyperventilate and do it again. Hyperventilating blows off CO2, and that gives you more time before levels rise to force you to breathe (breathe hold break point). Oxygenation continues to occur by passive alveolar exchange and this is fully evident by the same lab test that measures CO2 (an air blood gas, ABG measures both CO2 and O2). For the article to suggest that the test is dangerous is inaccurate at best, and likely disingenuous.
Second, Texas State Law requires a hospital to give a ten day notice before removing life support against family wishes in cases the hospital deems futile. The purpose of the delay, by law, is to allow a family time to effect a transfer to an accepting facility. The article suggests that the hospital is refusing such a transfer from an accepting facility yet the article also subtly admits that the other hospital hasnt actually accepted. The article says that insurance is pending. Translation: the other hospital hasn’t accepted yet. EMTALA requires a hospital to accept patients for higher levels of care without regard to insurance. In this case, the accepting hospital is not a higher level of care (the current hospital can provide ventilatory support to children), rather, it’s a lateral transfer. For lateral transfers, accepting hospitals can require proof of insurance coverage prior to accepting transfer. This article admits that is the case here. So, to say there is an accepting hospital is inaccurate at best, and likely disingenuous.
It’s not that I don’t agree with the premise that the hospital would be wrong to terminate support. My point is that the article has misrepresented what is going on, and has done so egregiously enough to cast its whole POV in doubt. After reading the article, I’m not sure I believe anything being advocated in it.
For the record, I have decades of critical care experience and currently work extensively with EMTALA and lateral transfers, all in Texas. I’m an expert on these issues which is why the errors presented stand out for me. I fortunately do not work in a hospital that would engage in the behaviors hinted in this article, and if I did, I’d quit before I complied. That said, I’m not sure that the hospital in the article engages in such behaviors, at least not from reading this article. There’s more to this story than was told.
Two more points:
If there were already an accepting hospital, then why is the article asking for help in finding an accepting hospital? If the ‘offending’ hospital won’t transfer to one accepting hospital, why would it do so for another? This is yet another indication that there is not yet an accepting hospital.
Second, the article cites second hand a doc that says a cerebral flow scan isn’t indicated and uses this as evidence against brain death. But. The second hand account of what the doc said was that the test wasn’t indicated because the brain was too swollen for blood to flow into it. So, what the doc actually said was that the child is brain dead and the mechanism of death (hypoxic - lack of of oxygen - injury during prolonged resuscitatation) is such that a flow study is a waste of time.
No blood flow to the brain equals death. For the SAME reason you can’t get tagged blood flow into the brain, you can’t get oxygen either. This is why the child is apneic (lack of spontaneous breathing is in fact an ominous sign). My point is that the article used this comment to support its position when it does just the opposite.
Your skull is a box. It holds three fluids: blood, water in tissues, and CSF. If one of these is out of balance, pressures in you head quickly build to lethal levels. In this case, the doc suggesting that a blood flow test is pointless is saying this is so because the tissue are so swollen as to crowd out the ability of blood to flow.
If you want to get technical, cerebral profusion pressure is equal to mean arterial pressure (the third number rarely mentioned in a BP reading that appears in parentheses after the sys/dis) minus ICP intracranial pressure. My guess is that the child has some sort of ICP monitors attached to his skull (there are several types). This is why they likely know there is pressure (aka swelling) and this is likely why the doc knows the test is pointless. In all likelihood, the CPP is far less than the minimal pressure to profuse the brain, and that is likely well documented. That’s the only scenario I can see in which the doc made such a comment. The fact that his comment was taken in support of the artifice’s primary point simply doesn’t line up with reality.
I do not, in fact, know anything about the current condition of Jahi's body. The closest I could come is some video footage released in October, but which could have been made at any time. It shows that Jahi's body displayed the Lazarus sign in her right hand and foot. It also featured a clip of the family's lawyer showing an MRI scan that ostensibly showed the good condition of Jahi's brain. What I saw, however, was that lower areas of the brain have disintegrated, and the cerebrum is shrunk, suggesting to me that the cells have lost water and are now in a leathery state (much like your skin's outer layers).
I have a PhD in life sciences and have never really studied anatomy. However, this blog post is written by a physician who is more familiar with gross anatomy, and explains certain issues like the supposed menses much better than I can.
Frankly, I'm amazed that a brain dead body can be maintained with heart continuing to beat for so long. I suspect, however, that the family may be in full scam mode by now. There is no independent assessment of Jahi's condition, no way to know whether the body is still hooked up to IVs and respirators. For all I know, they already buried her and are just trying to milk the situation for money. (I had sympathy for the family at first, but no more.)
This is a case of the parents not wanting to face fatcs, but wanting others to actually pay the bills for their fantasy.
Don’t know how this article plays into this story but here it is.....
https://charliej373.wordpress.com/2015/01/31/joe-cronin-surgery-a-success/
Surgery a Success
Posted on January 31, 2015by charliej373
By Charlie Johnston
I just wanted to let you know that Joey Cronin just got out of surgery. As I mentioned yesterday, they were giving him a tracheostomy so he can breathe on his own without damaging his throat and a gastric bypass so he might more easily be fed.
His Father, George, says the surgery was a success and that they will be feeding Joey tonight. It would not hurt at all – and might be a great help – for all those who called the hospital before to call them now. Tell them you know what an intense week it has been and thank them for giving such effective care after having had such a tense week. Their number, again, is 361-694-5000.
We fought with faith and fortitude when it was needed. Now it is time to bind up the wounds of battle. Keep praying for Joey and his family – and for an end to the culture of death. May the light drive out the darkness.
I am leaving the mountain this afternoon, so will be out of pocket for a bit. My apologies to the many who have sent messages to my email box that I have not yet responded to. I will be at it again Monday.
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