Family wants to keep life support for girl brain dead after tonsil surgery #1

[LyndyLoo]

The family said they were not allowed to see her until more than a half hour after she was transported from recovery to the ICU.

Firstly..IF this childs surgery required ICU care Post op..She would have totally bypassed the Recovery Room......Going to Recover Room (which means a 3-4 to ONE care ratio)..versus ICU one or more to one care...Means initial post-op from OR to Recovery by Aneasthetist and report given...means she was NOT intubated....and allowed to situp and suck on a popcicle...NO visitor would ever be able to supply a popcicle to anyone without clearances by Medical staff......
Guess Im NOT buying the post Cardiac Arrest..and Medical summaries not typed up until well after this horrendous thing.....CYA is very apparant to me...They should be glad I was on duty there!!!!

<modsnip>

Of course they haven't referred to her as their dead child. They refuse to accept the medical diagnosis that their child is deceased. Over half a dozen medical professionals and a judge has ruled that she is deceased. It's not an opinion that can be swayed. Whether they accept the diagnosis or not, Jahi is deceased.

Jahi. Is. Deceased.

Having her heart mechanically beat does not mean she is alive.

Who among us can declare true death...No one has even attempted to explain the connections of "Body..Mind and Soul"....Just because sudden blood loose caused electral brain activy loose....Does not mean ..that the soul of their loved one is dead.....Her young heart is beating on its own...no pacemaker..no extrernal mechanical devices....She is being supported with Respiratory Interventions..No one is making her heart beat.....

My point IS BBM She has a spontaneous Heart beat...NOTHING mechanical....

Only the family states her kidneys function- and her heart beats due to the vent.

Yeppp..ALL bodily functions coordinate..IF breathing stops..oxygen stops..within a few minutes....multiple systems start to breadown....Unless she already had Kidney failures going on...Kidney's if NOT failing will continue once perfusions oof oxygenated blood goes on.....right along with her heart contines to beat..because the system is oxygenated...CUT off the breathing repirations (Ventilator)...Eventually her heart will stop..Vital signs will drop into bucket....circulations cease...Kidney's are usually the last to stop...BUT once Breathing..Heart function ceases..Who really uses Kidney Function to claim anything.....Those in Complete Kidney Failure would wish her young kidney's were a match for them tho....But thats another thread..

 

[MyBelle]

Wouldn't it be safe to assume that her kidneys could have failed already?

I see that the family has put such sharp focus on her heart still beating (meaning she is still alive), but doesn't mention anything else besides breath which I attribute to the ventilator, obviously.

I almost frightened to guess what the condition poor Jahi's body could be in after two weeks. I really don't want that answer.

If her kidneys have failed, I doubt her heart is far behind. In her court declaration, the mother mentioned her beating heart, her functioning kidneys, her body temp and that she reacts to touch. For the hospital to try to attribute all of it to a ventilator is quite a stretch, imo.

 

[coeurfragile]

bbm, this may not be suitable for some, sorry.



Years ago the man next door shot himself in the head (suicide). He had a pacemaker, his heart continued to beat (pump). The paramedic had to remove/stop the pacemaker from pumping the blood out of his head.

But this is exactly my point. His heart was still beating, but he was not alive.

http://surgery.med.miami.edu/laora/community-services/brain-death

"The heart has its own pacemaker independent of the brain. As long as it has oxygen, it continues to beat. The heart could actually be removed from the body, placed in saline solution, given oxygen, and still continue to beat. This is why although the brain is dead, the heart continues to beat."

The only thing keeping her heart beating is the ventilator which is providing oxygen to her bloodstream.

 

[Zuri]

I wonder if Jahi's grandmother is an OR tech or scrub nurse. If she is, I hope that she can be a voice of reason for the parents. Having worked adult ICUs, PACU, Same Day Surgery and ER after 3 years of working med surg, I have seen a lot. There is human error. Medical personnel are not infallible. They are human. I have seen some lousy nurses and some lousy doctors, however there is usually a team working. All working for the well being of the patient. I may not have cared for one of the nurses I was working with, but if she needed help or her patient was in trouble, I was there and if I wasn't enough, more came.

There has basically been one side of this case. Complicated ENT procedures are done all the time. Unfortunately, not every case goes as expected or planned. This is a tragic case of what can go wrong resulting in Jahi being brain dead. The nurses and doctors are not going "Too bad". I have never known one to just give up and walk away when the patient was going bad. That is just not what we do nor is it in our DNA. Yes, I am speaking generally. I know there have been times when I was in way over my head, and when I asked for help, it came a runnin. My first day in the Surgery ICU at a teaching hospital, I was assigned a 30 year old man who was a fresh post op. I was at his bedside when his mesocaval shunt blew. I had never seen so much blood in my life. I was 26 years old and it was 30 years ago. I have never forgotten this patient. I did not have to handle his bleeding out alone. Other nurses came in so fast it made my head spin. We coded him and he died. We really really tried. The docs and the nurses, the respiratory therapists, everybody.

While I understand the difficulty both parties are in, it seems as though Jahi's well being has become secondary. Death with dignity is what every person deserves. IMO she is being short changed. Letting go is very difficult and I truly wish her mother peace. It is really ok to let her go. JMV

 

[SeekingJana]

That quote makes it all seem a bit Weekend At Bernie's.

I have to admit that even as an adult, I am mortified at the thought of the public talking about me wetting the bed, my weight, my body decomposing, my brain becoming liquid, me wearing nappies and people wiping my bum, my menstrual cycles... I'm a pretty free and open person, but it would still upset me. I would hope my family would let me go with dignity and now allow the world to be privy to the inner workings of my body. I imagine a 13 year old girl would be even more mortified.

I've taken care of people who were later determined to be brain dead. Flat EEGs and other legal criteria met.
I can tell you, for me and my co-workers, at least, the sanctity of that person's life and our other patients' lives was never questioned while they were in our care. We never questioned whether they were legally alive, we rendered comfort as best as possible to the highest standards.

It was not for me to ask why we were keeping a young man who had shot himself in the middle of the forehead with brain matter oozing out under pressure underneath the sterile dressing. It was not for me to ask why the elderly person in renal failure with a catheter and less than 10cc output was in my care.

I turned, I bathed, I soothed, I gave mouth care and skin care and basically I was this person's caregiver and their family's main liaison on my shift until the doctor did pronounce them deceased, did inform the family, and the funeral home did come for them.

Sometimes, people actually did turn blackish purple from the extremities up. I have smelled rotting bodies on ventilators. A nurse deals and puts her patient first. I have seen livor mortis set in long before the death was pronounced.

My co-workers and I made certain that they were as clean and neat and pretty for their family as possible at all times. Even in ICU, we did not keep family members from family in extremis such as I am describing IF they didn't disturb the other ICU patients. We had to have an understanding about their loved one's condition, and the needs of the other patients.

I've seen denial. I've seen extreme grief. And I and nurses ALL over this WORLD have tried and still do try to give our own comfort, dignity and peace to those who are leaving this world and the people who love them.

We never discussed anything about the person outside our shift. I never even thought of it. Whatever this family is saying is on them. And I think when it's all over, they may have regrets over not providing more dignity for Jahi.

 

[MyBelle]

I don't believe the NY facility will take this child. What will be next will be an appeal from the family. Possible there will be a second appeal when the family loses the first one. Meanwhile, this child will lay there, decomposing.

I don't believe the family WANTS any facility to take her. I agree with your take that there will be a trip to court. Either an appeal or federal and I think she'll stay either where she is or move to another facility nearby.

 

[otto]

I wonder if he'll actually file this tomorrow.

" California lawyer said Friday that he is prepared to go to federal court to force a hospital to insert breathing and feeding tubes into a girl who was declared brain dead after complications from a tonsillectomy.

Christopher Dolan told The Associated Press that he is drafting a civil rights lawsuit alleging that Children's Hospital Oakland's refusal to perform the procedures that would allow 13-year-old Jahi McMath to be transferred to a long-term care facility violates her family's religious, due process rights and privacy rights"

http://www.newschannel5.com/story/24315095/lawyer-charts-legal-moves-in-brain-dead-girl-case

I'm curious how the family's religious beliefs differ from general Christian beliefs.

1957: Pope Pius 12 ruled that there is no obligation to use extraordinary means to prolong life in critically ill patients and that it remains for the doctor to give the definition of the "moment of death"

2004: Pope Jean Paul 2 rejected withdrawal of nutrition and hydration as an option in cases of permanent vegetative state.





note: vegetative state is distinctly different from brain dead.

http://bcbt.upf.edu/bcncs/files/death_unconsciousness_NatureRevNeurosci05.pdf

 

[MyBelle]

I'm curious how the family's religious beliefs differ from general Christian beliefs.

1957: Pope Pius 12 ruled that there is no obligation to use extraordinary means to prolong life in critically ill patients and that it remains for the doctor to give the definition of the "moment of death"

2004: Pope Jean Paul 2 rejected withdrawal of nutrition and hydration as an option in cases of permanent vegetative state.





note: vegetative state is distinctly different from brain dead.

http://bcbt.upf.edu/bcncs/files/death_unconsciousness_NatureRevNeurosci05.pdf

I think the family questions the diagnosis of brain stem death and believes Jahi currently is in a vegetative state and might improve.

 

[SeekingJana]

Firstly..IF this childs surgery required ICU care Post op..She would have totally bypassed the Recovery Room......Going to Recover Room (which means a 3-4 to ONE care ratio)..versus ICU one or more to one care...Means initial post-op from OR to Recovery by Aneasthetist and report given...means she was NOT intubated....and allowed to situp and suck on a popcicle...NO visitor would ever be able to supply a popcicle to anyone without clearances by Medical staff......
Guess Im NOT buying the post Cardiac Arrest..and Medical summaries not typed up until well after this horrendous thing.....CYA is very apparant to me...They should be glad I was on duty there!!!!



Who among us can declare true death...No one has even attempted to explain the connections of "Body..Mind and Soul"....Just because sudden blood loose caused electral brain activy loose....Does not mean ..that the soul of their loved one is dead.....Her young heart is beating on its own...no pacemaker..no extrernal mechanical devices....She is being supported with Respiratory Interventions..No one is making her heart beat.....

My point IS BBM She has a spontaneous Heart beat...NOTHING mechanical....



Yeppp..ALL bodily functions coordinate..IF breathing stops..oxygen stops..within a few minutes....multiple systems start to breadown....Unless she already had Kidney failures going on...Kidney's if NOT failing will continue once perfusions oof oxygenated blood goes on.....right along with her heart contines to beat..because the system is oxygenated...CUT off the breathing repirations (Ventilator)...Eventually her heart will stop..Vital signs will drop into bucket....circulations cease...Kidney's are usually the last to stop...BUT once Breathing..Heart function ceases..Who really uses Kidney Function to claim anything.....Those in Complete Kidney Failure would wish her young kidney's were a match for them tho....But thats another thread..

I would like to respectfully address your first paragraph. Post- op patients are routinely taken to PACU for post anesthesia care by the staff where the anesthesiologist can observe and follow.
Depending upon the COMPLEXITY of the procedure in the USA, many patients are then transferred to ICU post op routinely.
ICU or SICU has a bed ready for them. PACU staff brings them to ICU.
The only difference is the level of care received after routine post anesthesia recovery.
Brain surgeries, organ transplants, heart surgeries, and some spinal surgeries are examples of those who are not emergency surgical patients who do go to PACU, then to SICU for a period of days, depending upon progress.

Are you a USA nurse? The level of care post op may also vary if you work at a city/ county hospital vs. a corporate- owned facility. City/ county is more likely to skip a step for cost control, IMO.

 

[otto]

I think the family questions the diagnosis of brain stem death and believes Jahi currently is in a vegetative state and might improve.

If six doctors have completed the normal tests that are done to assess brain activity, and all have independently concluded that the child is brain dead (well past a vegetative state), why is the family refusing to accept this?

Could there be a general distrust of medicine? If so, that has nothing to do with religion or privacy.

 

[momrids6]

I think the family questions the diagnosis of brain stem death and believes Jahi currently is in a vegetative state and might improve.

Her mother states her daughter died, was brought back, and is now brain dead:

http://www.news.com.au/lifestyle/he...move-her-tonsils/story-fneuzlbd-1226785309143

Her mother has stated numerous times she wants her out of CHO.

 

[MyBelle]

If six doctors have completed the normal tests that are done to assess brain activity, and all have independently concluded that the child is brain dead (well past a vegetative state), why is the family refusing to accept this?

Could there be a general distrust of medicine? If so, that has nothing to do with religion or privacy.

According to court documents, the family is refusing to accept it because they don't believe it because of their faith.

Of course there could be a general distrust of medicine but distrust may also involve a lot of factors having nothing to do with religion. The grandmother apparently is a surgical nurse so it might have more to do with her own experiences.

 

[MyBelle]

Her mother has stated numerous times she wants her out of CHO.

Can't say that I blame her.

 

[Cubby]

I am concerned with the other children that are watching Jahi lay there in this state.

I feel that this family will not take Jahi's passing seriously, and with grace, until Jahi is physically showing death.

Breaks my heart that Jahi didn't get to go home and have Christmas with her family. As a mother, I so wanted that.

It's just not the case, and other children are involved here... from their own family to those in the hospital.

It's all so very unsettling, IMO.

My thoughts have been with the children, too. I can't imagine what this circus is doing to her siblings.

 

[shana]

I think the family questions the diagnosis of brain stem death and believes Jahi currently is in a vegetative state and might improve.

How very sad!

 

[MLO]

I've taken care of people who were later determined to be brain dead. Flat EEGs and other legal criteria met.
I can tell you, for me and my co-workers, at least, the sanctity of that person's life and our other patients' lives was never questioned while they were in our care. We never questioned whether they were legally alive, we rendered comfort as best as possible to the highest standards.

It was not for me to ask why we were keeping a young man who had shot himself in the middle of the forehead with brain matter oozing out under pressure underneath the sterile dressing. It was not for me to ask why the elderly person in renal failure with a catheter and less than 10cc output was in my care.

I turned, I bathed, I soothed, I gave mouth care and skin care and basically I was this person's caregiver and their family's main liaison on my shift until the doctor did pronounce them deceased, did inform the family, and the funeral home did come for them.

Sometimes, people actually did turn blackish purple from the extremities up. I have smelled rotting bodies on ventilators. A nurse deals and puts her patient first. I have seen livor mortis set in long before the death was pronounced.

My co-workers and I made certain that they were as clean and neat and pretty for their family as possible at all times. Even in ICU, we did not keep family members from family in extremis such as I am describing IF they didn't disturb the other ICU patients. We had to have an understanding about their loved one's condition, and the needs of the other patients.

I've seen denial. I've seen extreme grief. And I and nurses ALL over this WORLD have tried and still do try to give our own comfort, dignity and peace to those who are leaving this world and the people who love them.

We never discussed anything about the person outside our shift. I never even thought of it. Whatever this family is saying is on them. And I think when it's all over, they may have regrets over not providing more dignity for Jahi.

I know the subject of your post was sad, but it really made me smile- you sound like a lovely, respectful nurse. People, alive or dead, deserve their dignity if at all possible. In this case it is possible but her family are denying her privacy and dignity.

 

[SophieRose]

I talked to a friend today whose 50ish neighbor (I had met him and his wife at parties at her house) was declared brain dead after a heart attack several years ago. The wife was told after a few days that he was brain dead and there was nothing more that the hospital could do for him. She asked about having him go to a rest home or come home with her. The doctor told her that insurance would not pay for any future care. My friend said that the neighbor's wife was the one who decided to discontinue the support. I don't know how there is a question as to who makes the decision when it has to be done. Maybe timing as when it's done but maybe they need to set legal limits on that. My friend said that the body did have reflexes as mentioned in one of the articles someone posted.

 

[SeekingJana]

I know the subject of your post was sad, but it really made me smile- you sound like a lovely, respectful nurse. People, alive or dead, deserve their dignity if at all possible. In this case it is possible but her family are denying her privacy and dignity.

Thank you. I believe I am speaking for ALL nurses, for ALL of us have been in the position to take care of the dying. Care-giving is not just for those lucky patients who will go home and play golf, or go back to school, or volunteer at their son's school. It is also for the dying and that does include the " legally" dead who are in a bed in ICU or on a medical unit.

It took maturity for me to realize that my goals of care for the dying were to provide comfort for my patient, for we do NOT know what a body can feel, and to inform and support the family as best as possible at all times.
It does not matter what the family does, if it is according to their beliefs and a facility can accommodate them, then we are expected as nurses to do so. Let the hospital Administration deal with the administrative aspects, we are caregivers!

That's why I cannot call Jahi " a dead body". To the nurses who are still taking care of her, she is a patient who needs them. I stand with them in a show of support.
CHO RNs, you are in my thoughts and prayers. :seeya:

 

[momrids6]

“We didn’t want her to be removed from life support but the decision is out of our hands because it’s been declared a legal death,” said Omari Sealey, 27, the uncle of Jahi McMath, an eighth-grade student at the E.C. Reems Academy of Technology and Arts in Oakland.
Sealey said Jahi went to Children’s Hospital Oakland on Dec. 9 to have her tonsils removed to cure a sleep apnea problem.
But he said Jahi had trouble breathing and suffered “an enormous amount of bleeding” after the surgery, which had been expected to be routine.
Sealey said, “No one knew what was going on” for several days and on Thursday Jahi went into cardiac arrest and was declared brain dead.

http://news.kron4.com/news/13-year-...nsil-surgery-to-be-removed-from-life-support/

 

[SwampMama]

Headline:Jahi McMath: Mom and lawyer say only remaining option for brain-dead girl is a New York care facility http://www.mercurynews.com/california/ci_24812054/jahi-mcmath-mom-and-lawyer-say-only-remaining

I'm sure this has been linked before but I wanted to point out the headline. If the mom and lawyer acknowledge that this alleged NY facility is the "last hope" then WHAT will they do when it also refuses (and rightfully so) to take Jahi.

Will they FINALLY accept the facts and allow this deceased child to rest in peace? Or will they appeal and try to drag this on further? Something tells me that they will try to drag this on further. Hopefully their appeal will be declined, as it is abundantly clear that Jahi is indeed gone and no legal ruling, nursing home or fundraising can change that.

It is time that they accept the facts and this is obviously this is God's will for Jahi and take comfort in their faith that Jahi's soul is in a better place and her body can finally be laid to rest.