Sweeper2000
Well-Known Member
- Joined
- Oct 24, 2022
- Messages
- 2,074
- Reaction score
- 5,507
In my opinon:
Anything that causes increased intra-abdominal pressure could cause a collapse if the pressure is high enough. This is because the abdominal contents will displace the space needed for the lungs to expand. This idea is not in question; it is basic physiology. The lungs need room to expand while you breathe. If the increased intrabdominal pressure is not resolved then even positive pressure ventilation may not be able to overcome the resistance and permit a resuscitation. Typically babies have increased intra-abdominal pressure due to illness or after surgery. They are already critically ill and sometimes on a ventilator to begin with. Usually there is little that can be done about the intra-abdominal pressure in those cases - sometimes they have to surgically open the belly or open it back up and sometimes that helps and sometimes it does not.
The reason why Dr. Evans has hypothesized that air in the NG tube contributed to, for instance, Baby I's first 3 collapses, is because there was evidence of excessive air in the stomach, *and* the baby was able to be resuscitated. On the other hand, babies who are suffering from the illness or surgical complications I described earlier... they aren't suddenly "fine" once the resuscitation is over. They're still very ill. Evans suggests that Baby I eventually died of an air embolism during her fourth collapse, when they were unable to resuscitate her.
As for your second bolded question, can you explain more what you are wondering here?
![]()
Lucy Letby trial: Baby girl 'killed by injection of air into her stomach'
Prosecutors alleged Lucy Letby tried three times to kill the baby girl before she succeeded on her fourth attempt.news.yahoo.com
I get what your saying. So Babies in an already weakened state would be more prone to more severe effects from Compromised breathing in a collapse?
i suppose the second question is Related to the first. Dr evans suggestion in one about the “robust” resus efforts what exactly does he mean by that? would this Particular resuscitation have been any different from any other or indeed any different from any other collapse in the cases?
if there are also different levels of skill in different resus efforts then does it follow that the routine approach to resus efforts is documented to the degree that would enable investigators to distinguish one effort from another? I understand we have thorough documentation for medication ie adrenaline but not sure about the physical side of resus efforts. Just thinking that if they didn’t document the decompress in the stomach how do they know it wasn’t all in vain?