Family wants to keep life support for girl brain dead after tonsil surgery #2

[Linda7NJ]

Last snipe, promise

Dr. DeGiorgio confirms this observation. Although the heart does function independently, he concedes, "when somebody is truly brain dead, after several days the heart function deteriorates severely. So the heart may function temporarily without a functioning brain, but over a period of a few days, the basic rhythm of the heart will deteriorate, and the patient's blood pressure will deteriorate."

Thus it is possible to test the diagnosis of brain death by continuing to ventilate the patient. If cardio-respiratory death — that is, death in the classical sense — has occurred, in a short time the patient's heartbeat will slow and become irregular, despite continued ventilation. Eventually, no amount of artificial life support will be able to sustain the heartbeat.


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[Isabelle]

I think they're doing it on purpose. Not to be considerate but to remind people that she is legally deceased despite the assurances of the family that she will wake up if people just wait long enough.

Speaking of the patient on a ventilator as "the body" would be highly inappropriate and disrespectful. I would hope anyone that does that is reported to their respective licensing boards. As an RN I would not tolerate that kind of behavior from anyone. Even the deceased are are to be treated with utmost caring respect at all times!

 

[Isabelle]

I just wish the hospital would tell use why she bled out so badly and wasn't taken back to surgery STAT!

 

[Isabelle]

So by that standard, after a reasonable period of time if someone isn't well enough to breath on their own, improve enough to walk out or be wheeled out in a chair someday they don't deserve to live? After two weeks in a coma, let's yank out that plug and call it over!

Well let's start the unplugging now!

Look at all $$$$$$ that would save!!!!!


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Guarantee that if you had an insurance policy that was a high payer, you would be brain dead for a very long time. Administration would be thinking, look at all the $$$$$ we can make. I have been there and seen that!

 

[jjenny]

I just wish the hospital would tell use why she bled out so badly and wasn't taken back to surgery STAT!

The hospital might not know why she bled since there hasn't been an autopsy.

 

[SophieRose]

http://www.foxnews.com/health/2013/...rain-dead-says-ny-facility-is-last-last-hope/

Meanwhile, a state appeals court on Tuesday refused to order the hospital to insert the tubes, saying the issue has to go first to the lower court judge who has ordered the hospital to keep the girl on a ventilator until Jan. 7 pending the family's appeal. The 1st District Court of Appeal said it would consider the issue at a later date, if necessary.

 

[Isabelle]

The hospital might not know why she bled since there hasn't been an autopsy.

True about not knowing about the bleeding, but I would ask how many times the surgeon was called and why she wasn't returned to surgery. It is rare for a tonsillectomy patient to go to ICU, and even though this girl had extensive surgery, I would bet the ICU nurses were not familiar with what is normal following that type of surgery. Instinctively, the nurses should have known the bleeding was a major emergency that needed to be acted on. I've worked as an RN for 27+ years and you would be surprised at the number of nurses I have worked with that should be declared brain dead (incompetence wouldn't even cover it).

 

[wendiesan]

Hi. Despite the tragic circumstances discussed in this thread, I'd like to extend my wishes to everyone for a joyous, prosperous and healthy 2014. Agree, disagree--every person has contributed something that helps shine more light on a subject that will sooner or later touch every one of us. Sometimes the words read like electric shocks, sometimes the posts demand deep consideration. Thanks to everyone who shared their personal stories, to those who practice medicine in various capacities for sharing such specific expertise, and to the generalists who keep putting "facts" into a broader context. Thanks mods for being present, yet invisible.

I posted earlier that NW told a reporter that she had lost consciousness while Jahi was bleeding in the ICU but did not provide a link at that time, so here is the information. The comment was made to Matthias Gafni of the San Jose Mercury News. http://www.mercurynews.com/breaking-news/ci_24775261/jahi-her-mom-and-13-days-at-childrens

"Unable to speak and drowsy on morphine, Jahi wrote her notes, Winkfield said, asking "Is this blood?" "Why am I bleeding so much?"

Winkfield's mother, a nurse, replaced her in the ICU, but when Winkfield heard an alert called for Room 10 -- Jahi's room -- she said she rushed back to find staff attempting to restart her daughter's heart. Then Winkfield blacked out, she said, and was admitted herself.

She found out her daughter was in a coma from her own first floor hospital bed, she said."

In the context of the discussion regarding a timeline or sequence of events in ICU, the subject of perceived rather than actual time had arisen. I mentioned this event since NW would not have been able to corroborate SC's memory of the timing of different actions as she was no longer in the ICU. The stress of something like this happening would certainly have affected a person's memory of how long it took things to happen as well as the sequence in which several activities happened.

This was not a criticism of NW. Lord knows if one of my children was hemorrhaging in the way NM describes, I'd probably have fainted too.

 

[katydid23]

Oh my gosh! I can't believe what I am reading:facepalm:

Is human biology not taught over there in school? What an absolute shame. This is why science MUST be compulsory and MUST be better funded.

Can you imagine how different situation would be if the mother had even a basic understanding of biology of this situation?

Jahi's Grandmother is a registered nurse. She surely understands the human biology involved. But it is too emotional and tragic for them to accept.

 

[Sonya610]

"Unable to speak and drowsy on morphine, Jahi wrote her notes, Winkfield said, asking "Is this blood?" "Why am I bleeding so much?"

Sorry if I missed it but do we have a time line on how long this bleed out went on? I seem to remember 30 minutes being mentioned?

Plus Jahi was not a small child, do we know how much she weighed? I am guessing 140 lbs or so? Doesn't body weight directly correlate to the amount of blood in ones system? While "children" may crash faster than adults considering her age and size I don't really think physically she would really be considered a child, she was likely heavier than many small adult women.

I know a lot of this won't come out until (and if) the medical records are released or this goes to court but maybe some with knowledge could share the timeline and what is usually done in these situations.

Suctioning up 4 pints of blood just doesn't seem like a very good plan. How long would it take to sedate, do a trach or drop a breathing tube and pack the area with hemostatic gauze or something until a surgeon could cauterize the bleeding?

 

[Donjeta]

Speaking of the patient on a ventilator as "the body" would be highly inappropriate and disrespectful. I would hope anyone that does that is reported to their respective licensing boards. As an RN I would not tolerate that kind of behavior from anyone. Even the deceased are are to be treated with utmost caring respect at all times!

They're damned if they do, damned if they don't. If they speak of a deceased person as if she is a living patient on a ventilator they will be seen as more horrid for starving her to death and not giving her potentially life saving surgery.

 

[SophieRose]

I find it interesting about the possible shift change. Wasn't she scheduled for surgery at noon? The hospital I've been to the most has a 4 pm shift change.

http://www.nbcbayarea.com/news/local/Oakland-8th-Grader-Brain-Dead-After-236015681.html

At the same time, Sealey said it appeared to the family as though the nursing staff had vanished during what seemed to be a shift change. In the family's minds, there didn't seem to be enough hospital staff in the room to help. The family started suctioning blood themselves; Jahi's grandmother, Sandra Chatman, is a nurse at another hospital.

 

[Donjeta]

http://www.latimes.com/opinion/comm...n-dead-20140102,0,395550.column#axzz2p90PhAYB

Jahi McMath, alive in social media
The sad case of Jahi McMath, brain dead following surgery, has become catnip for social media. But part of the emotional fever rests on a confusion between brain death and a coma.

http://www.latimes.com/opinion/comm...n-dead-20140102,0,395550.column#ixzz2p97Hchfm

 

[fruity]

http://www.latimes.com/opinion/comm...n-dead-20140102,0,395550.column#axzz2p90PhAYB

Jahi McMath, alive in social media
The sad case of Jahi McMath, brain dead following surgery, has become catnip for social media. But part of the emotional fever rests on a confusion between brain death and a coma.

http://www.latimes.com/opinion/comm...n-dead-20140102,0,395550.column#ixzz2p97Hchfm

I read this earlier and thought it was good. I was on my phone though, and couldn't grab the link. Thanks for posting it, it is worth reading.

 

[kytty]

The family has also put itself between a rock and a hard place with all of the court filings. CHOs legal position is that she is legally and medically deceased and that finding has been upheld in court. In order to avoid setting any precedent of 'treating' the legally deceased they fight tooth and nail not to provide any other treatment to Jahi or allowing any outside doctor to provide that treatment to her at their facility (beside maintaining the 'status quo' vent support as ordered by the judge). So again, this is way way past being about Jahi now and I wonder if the family knows that or not.

Being truly brain dead, and as such having the brain after that death rapidly begin to deteriorate, I think the cases you mentioned Lindan7, are most likely cases of misdiagnosis. We see all the time sadly that drs are wrong and make mistakes. Unfortunately and horribly sadly, I don't think a misdiagnosis was made in Jahi's case.

 

[Elley Mae]

So at what time does the court call out the lies from the side of the patient? I mean can lies keep being said and used as a means of getting more time in the hopes that she will start coughing and wake up? If the place does not actually exit (not finished) what was all the donating about and what airlift would get involved without a destination? I was/am under the impression that the delay was for lining up travel plans? Where are they going? I think the judge slipped on this, it has gone too far. I find it funny ( not ha ha funny) that they are just now concerned about food. 23 days and now that's the problem. jmo idk

 

[Herat]

Jahi's Grandmother is a registered nurse. She surely understands the human biology involved. But it is too emotional and tragic for them to accept.

That is incorrect.

She is a LVN, not an RN and she works in a Kaiser facility.

There is a huge difference in education, qualifications, and duties between and LVN and and RN.

She is NOT an RN.

 

[MissJ]

That is incorrect.

She is a LVN, not an RN and she works in a Kaiser facility.

There is a huge difference in education, qualifications, and duties between and LVN and and RN.

She is NOT an RN.

Thanks for clearing that up.:twocents::moo: It truly explains a lot.

 

[Herat]

From Jahi's family's facebook page an hour ago

"We Are Asking A Brave Doctor To Step Up & Agree To Do The Tracheotomy Procedure"

I thought they said they had a pediatrician to be with Jahi as she flew to the facility. So is their pediatrician not skilled enough (or not courageous enough) to do the trach procedure?

Pediatricians are not qualified to perform elective tracheostomies.

They do not have hospital privileges to do this surgery and their malpractice insurance would probably cancel on them for agreeing to do this.

I doubt any qualified and licensed physician wants to voluntarily put themselves in the middle of this circus.

 

[MissJ]

JMO the family is stalling. The facility in NY is not done and may never be a licensed inpatient facility when it is finished. They seem to be hoping the court will keep giving them more time. Dr's make mistakes, yes but these tests don't lie. Six Dr.'s read them the same way. I have never seen anything incompetent in regards to ICU nurses and I have known many. They work hard and its always a team effort when it comes to patient care. Kudos to them for doing their best under trying circumstances.