Sorry SO long, but I NEEDED to test all this out for myself. So I’m passing along in case anyone wants to “check” it. Totally understand if no one reads….its LONG.
KEEP IN MIND:
Fahrenheit is not linear, so when doing math with Celsius and Fahrenheit, you have to add/subtract in Celsius THEN convert to Fahrenheit.
Ok so here we go….
I looked in depth (over 28 hours
) into “accidental” / not illness or surgery related hypothermic patient warming methods and how many degrees per hour each method raises core body temp.
The methods are broken down into 2 categories, passive and active. For THIS exercise, in order to believe BOTH the CW (he was out on the lawn 5hrs 45 mins) AND the ER (John was 80.1F / 26.7C) then warming methods HAD TO have increased his core temp A LOT — around 24.7 C - 26.7C. We are talking raising someone’s temp by 77F - 80F. It definitely can be, has been, and is done, but only when the Cadillac of warming methods is used, ECMO (Extracorporeal Membrane Oxygenation), and used for several hours. ECMO was not used on OJO, likely for 2 reasons:
—Severe brain injury due to head trauma “disqualifies” a patient from ECMO primarily due to the increased risk of bleeding complications associated with the required anticoagulation, and the potential for these complications to exacerbate intracranial hemorrhage
—There isn’t an ECMO unit at Good Samaritan in Brockton, MA
Moving onto Passive warming. It is not effective on a patient less than 29.4 C / 85 F because patient is unable to thermoregulate. So passive methods are used to stop heat loss, not increase, in such cases. OJO, IF on the lawn 5 hrs 45 minutes, would have been 0-2 degrees C / 32-36F therefore unable to thermoregulate. (He would have been unable to thermoregulate at 80.1 F the temp they say he was at intake.)
Passive Warming Methods
— move out of cold to warm area (heated room or ambulance in this case), remove wet clothes, apply blankets (increase of .5 - 1 degrees C/ hour IF thermoregulating)
ACTIVE warming methods used on OJO according to Dr. Rice’s testimony:
— Warm Intravenous fluids via IV (increase of 1-1.5 degrees C/ hour)
— Forced Air Warmth, such as the Bear Hugger (increase of 2-2.5 degrees C/ hour)
— Warm humidified ventilation via mask or ventilator (increase of 1-2.5 degrees C/ hr)
TIMELINE (from testimonies):
~12:30am OJO is alleged to have been run over
6:03am OJO is found
6:04 am 911 was called
~6:10am ambulance arrives on scene
~6:15 am stretcher is pulled onto lawn to transfer OJO
~6:20am ambulance leaves
6:47am OJO arrives in ER unit still asystolic with a core body temp of 80.1 degrees
7:50am OJO is pronounced dead
Based on timeline, from approx 6:15am to 6:45am OJO is IN ambulance where we know passive warming methods were used according to testimony. For THIS exercise we are ASSUMING he has been out in the cold since around 12:30am. So we can estimate his core body temp when put inside ambulance to have been 0 to 2 C / 32 - 36 F based on science in link at bottom of post and the chart at bottom of post that comes from the link.
The passive methods EMT used likely didn’t raise his temp. Only maintained it. (As established earlier, OJO was not able to thermoregulate.) But let’s go ahead and be generous with warming him up and ASSUME for this exercise passive worked, and they raised his temp .25 C in the half hour he was in the ambulance. (The lower end of passive increase range after a half hour.) So he would now be .25- 2.25 C / 33-36 F at 6:47am upon arrival to ER.
In the ER they attempted to raise his core temp for 1 hr before pronouncing him dead at 7:50 am according to timeline, but Dr. Rice stated in his testimony (linked below) that they attempted warming methods on him for a half hour. But we need to get his temp up a LOT, so let’s go with the timeline and be generous saying they warmed him from the time he arrived until TOD, 1hr.
Dr. Rice said in his testimony they used a bear hugger and warm intravenous fluids. I’m going to assume they were also giving him warm ventilation since that’s a pretty standard active warming method and Dr. Rice’s saying he was intubated to help breathing. & again, I need to be generous with warming him in order to get to 80.1F / 26.7 C .
To determine total core body temp POSSIBLE INCREASE, I used the lower range of possible increase for passive methods since OJO couldn’t thermoregulate, and the HIGHER end of possible temp increase range for each of the Active warming methods.
TOTAL POSSIBLE CORE TEMP INCREASE FOR EACH METHOD (passive in ambulance plus active in ER):
— Passive methods: .25 C
— Warm IV fluids: 1.5 C
— Forced Air Warmth/ Bear Hugger: 2.5 C
— Warm ventilation: 2.5 C
TOTAL POSSIBLE CORE TEMP INCREASE IS 6.75 C (44.15 F)
So, 0-2 C (temp he would have been when put inside ambulance after 5hrs 45 mins on lawn)
PLUS 6.75 C (total possible core temp increase from both passive and active warming methods)
EQUALS 6.75 to 8.75 C /44 to 48 F at time of death.
44-48 F is the TOTAL POSSIBLE core body temp he could have been at 7:50am if REALLY left out in those conditions for 5 hrs 45 minutes.
NOW, let’s do a
SECOND exercise and go backwards with the temp they say he REALLY was.
Dr. Rice said he was 80.1 F (26.72 C) upon arrival in the ER. He also said “despite efforts for approximately 1/2 hour, there was not a significant warming of his core temperature.” So maybe they were only able to MAINTAIN his temp, so he arrived at 80.1 F and was the same at TOD??
Still though, for this exercise, let’s ASSUME they were successful and stick with 6.75 C being the total amount his core temp could have possibly increased in both ambulance passive methods and ER active methods combined.
We are working backwards from what the ER says he was, 80.1 F / 26.7 C, to determine what he could have been at 6:17am BEFORE warming methods began in ambulance.
The Math:
80.1 F / 26.72 C (temp in ER)
MINUS 6.75 C (total possible increase by warming methods)
EQUALS 19.97 C / 68 F (temp he would have been when FOUND)
So it’s and
more likely he was found around 68F / 20 C based on the medical records, warming methods used, and charted core body temp upon intake.
According to the hypothermia chart 68 F/ 19.97 C occurs at approximately 1 hr and 40 mins exposure in the conditions that night in a light layer of clothing. So we can assume from this second exercise he was put out on the lawn around 4:37 am/ KR could NOT have hit him at 12:30am.
We have to choose who/what we believe, the CW or the medical records. We cannot believe both because it’s scientifically impossible for both to be true. The numbers are WAY too far apart to believe both, and science doesn’t lie. He could NOT have been warmed by more than 6.75 C during the 1.5 hours he was under medical care.
It is scientifically IMPOSSIBLE for him to have been out in the elements for 5 hrs 45 mins and have been 80.1F / 26.7C in the ER even AFTER warming methods.
Now for the
THIRD exercise, let’s be
most accurate with the science. (We are no longer being generous in an attempt to get him to 80 F from 32-36 F, what he would have been on the lawn after 5 hrs 45 mins.)
So being totally true to science, we know he couldn’t thermoregulate. So the passive methods in ambulance didn’t increase and only maintained his temp. And considering they weren’t having success, the active methods in ER likely only warmed him at the lower possible ranges, collectively that would be 4 degrees C total possible warming. So if he was raised by 4 degrees C, he was
most likely 22.7C / 73F when found.
The math:
26.7C in ER
MINUS 4C (MOST likely amount his temp was able to increase from warming methods)
EQUALS 22.7 C / 73F when found
22.7 C occurs after 1 hr 15 mins in those conditions, so he was
most likely put out there around 5am, 1hr 15 mins before put in ambulance. And keep in mind alcohol and blood loss quickens temp loss. Based on this staying hard core true to science exercise, exercise 3, I’m wondering if JM called someone after OJO’s niece called her at 4:53am and KR said i need to find John.
Let’s look at what happened around 5am, the time he would have been put out there according to exercise Three done with with 4 C being the total amount they were able to increase to get him to 80.1 F.
4:53 a.m.: Jen McCabe receives a call from John O’Keefe’s niece, who was told to call her by Karen Read, and learns that O’Keefe did not return home the night before. After the niece speaks briefly to JM, the niece gives the phone to Read, who decides to drive to McCabe’s home.
5 a.m.: Karen Read calls Kerry Roberts. She tells Roberts O’Keefe did not come home the night before and asks her to help look for him. Roberts calls the police non-emergency line to ask if there were any plow accidents, as well as Good Samaritan Hospital, before driving to meet Read and Jen McCabe at McCabe’s home.
It is my theory, that SOMEONE around 5am called someone at the Albert’s residence to make sure they moved OJO onto the lawn before they arrived with KR at 6:03am. SOMEONE then put OJO out there around 5am because Biology/Science doesn’t lie.
In summary, anyone choosing to believe OJO was hit by KR around 12:30am must
also say the ER’s recorded core body temp was very very wrong. WAY off.
View attachment 593630
Cold Weather Survival Time – Body Physics: Motion to Metabolism
Dr. Rice’s testimony (ER doc)
At the 6:45 mark he says there was a breathing tube and arrived intubated
At the 15:55 mark he states the warming methods used
At the 17:40 mark he says “despite efforts for approximately 1/2 hour there was not a significant warming of his core body temp.”
