A poster asked if I could explain more from a previous post.
Here is the first study link. Extra corporeal membrane oxygenation (ECMO) is a kind of heart/ lung machine, that this study was researching to determine if ECMO improved survivability in adult drownings. The ECMO process "rests" the lungs when there is severe damage. There is no indication BK was ever on ECMO, although I'm sure they have it at a facility as renowned as Emory. The study has a lot of other pertinent statistics and info in it, which is why I used it.
http://www.sjtrem.com/content/22/1/77#B2
A quote from this article is explaining the purpose of the study, and citing previous studies with statistics from adults who experienced near drowning, WITH cardiac arrest at the scene of the accident.
According to the World Health Organization, more than 500,000 deaths each year and 0.7% of all deaths worldwide are due to unintentional drowning [1]. The outcome of patients after near-drowning is mainly related to anoxic encephalopathy.
A previous study reported a survival rate of only 1.7% in 1,669 adult drowning patients who were in a cardiac arrest when the emergency medical services (EMS) arrived. Of these, only 0.7% survived with a favourable neurological outcome at 1-month after the near-drowning incident [2].
This study of 1669 patients is from this study: (I'm sorry, cannot provide full text, only abstract)
http://www.ncbi.nlm.nih.gov/pubmed/12528781?dopt=Abstract&holding=f1000,f1000m,isrctn
These are very important statistics, and originally my comments were that someone like a celebrity doctor commentator could present these kind of outcome-based statistics in their commentary. The purpose of that would be to NOT talk about BK's situation specifically (which the commentator cannot do), but would provide comparison statistics for patients who also experienced a few things that we DO know with pretty good certainty about BK: That she experienced near drowning, unwitnessed, with an unknown time of submersion, and that she was found in cardiac arrest at the scene, and was still in cardiac arrest when EMS arrived.
So, breaking down the statistics in the Critical Care Medicine retrospective study (
http://www.ncbi.nlm.nih.gov/pubmed/12528781?dopt=Abstract&holding=f1000,f1000m,isrctn )
- 1669 adult records were reviewed from near drownings
- ALL of THOSE 1669 patients reviewed were in full cardiac arrest at the scene (with various periods of witnessed and unwitnessed submersion times)
- Only
1.7% of the 1669 patients (or,
28 patients) survived
at all to hospital admission and discharge, and various amounts of time after that.
- Only
0.7 % (
we get less than one patient statistically of the 28 survivors) of the 1.7%
who survived with a heartbeat to discharge from the hospital, had any kind of "favorable" neurological condition.
-"Favorable", meaning breathing independently, with some ability to awaken and have some level of consciousness. Favorable, in this case, DOES NOT mean completely neurologically intact, walking, talking, and functioning in society.
Essentially, what this study of 1669 near drownings with cardiac arrest at the scene shows us is that out of 1669 people in roughly identical situations, only .19 (less than one patient) of them will survive with some level of favorable neurological outcome.
1641 of them (or, 98.3%) will die at the scene, or during hospitalization. The other 27 survivors are permanently vent dependent and PVS. (In order to have even 1 or 2 patients with some level of favorable neuro outcome, we would have to extrapolate the original group of 1669 adult drownings with cardiac arrest up to 10,000 drownings with cardiac arrest.)
The survival odds in this study (and I can't quickly find any studies with a larger population than 1669 patients) mirror those of patients with trauma-induced cardiac arrest (such as from car accidents or falls from great distances onto the head) at the scene of the trauma. Any kind of complete cardiac arrest (aysytole) in an out of hospital cardiac arrest (OHCA) situation has very low survivability, with the exception of cardiac arrest from an electrical malfunction inside the heart (such as v-fib or v-tach)-- which is why we have AED's out and about in all areas of society now. The reason the survivability continues to be so low, is that we can't quickly "fix" the cause of the problem at the scene-- major trauma, or prolonged oxygen to the brain. We can "fix" electrical problems within the heart with an external defibrillator, hopefully before brain damage sets in. (Hope that makes sense!)
*Babies and kids are in a different category for drownings, but the outcomes are also, sadly, quite dismal. Of the kids who do have miraculous recoveries, nearly all of them had regained a pulse at the scene after CPR/ ACLS. I'm not going to pull the studies on babies, because they aren't relevant to BK's situation.
*And the bathtub water BK was found in, even if tap water cold, would not be "cold enough" to provide the level of cerebral protection that a fall thru lake ice would, to clear up that misconception.
Hope this is helpful. Sad and depressing as it is.
