Citation please, for these apparent factoids, which are at issue with two medical experts' testimonies -
"the speed isn't relevant".
"If it was a syringe rather than a machine used to administer the air there wouldn’t be a difference in speed of application."
Is it something you read in the defence cross-examination of the experts? A link is required.
Why do you doubt that a less than lethal dose could be administered, and why is the likelihood of a less than lethal dose smaller than otherwise?
Expert testimony -
Baby B
Dr Evans
Dr Evans tells the court the collapse was "very similar" to that of Child A, but what happened was "less severe".
He said "either the volume of air [injected] was less, or the volume of air in the circulation got there more slowly, or a combination of the two."
Mr Myers said it is a 'key aspect' that the inability to successfully resuscitate Child A had led to an air embolus. He adds that child B recovered, and that is "inconsistent" and "contradicts the air embolus theory".
Dr Evans: "
No it does not. We cannot do studies where we inject air into babies and see what happens."
He adds that
the volume and speed at which air is injected, along with the skill of the resuscitation attempts, can make a difference as to whether the baby survives or dies.
Dr Bohin
She adds that even if air was accidentally administered, there is an electronic pump system which would detect the air and stop the administration.
Dr Bohin explains to the court that could be bypassed further down the line by administering the air embolus via a connector normally used for administering drugs.
https://www.chesterstandard.co.uk/news/23075662.recap-lucy-letby-trial-tuesday-october-25/
Baby D
Dr Bohin
She says
all three collapses for Child D were "sudden" and "unexpected".
"They came out of the blue...she recovered very quickly with the first two, and
two of the episodes were associated with an unusual mottling of the skin.
Dr Bohin: "
She seemed to recover very quickly after the medical team's intervention and she was well again."
"Taking into account the sudden nature of the collapses and the very quick recovery...I was very clear it wasn't infection, so the conclusion had to be something unusual and odd."
Other conditions were crossed off as they 'didn't fit'.
She concludes the collapses were caused by intravenous air administration either through the UVC or the cannula.
Dr Bohin says with air embolus, the speed and quantity of the air administered depends on whether it is fatal.
She says the first two administrations of air would have been small, but the third would have been larger to cause circulation to stop.
Dr Bohin says the suddenness of the collapse, with skin discolouration, fitted with cases of air embolus, as did the presence of air found in the 'great vessels' on post-mortem x-rays.
Mr Myers says Child D recovered twice, which, in principle, is inconsistent with an air embolus.
Dr Bohin disagrees, saying it depends on the speed and volume of the air administered.
She said there is a treatment for air embolus.
Recap: Lucy Letby trial, Friday, November 11
this will take some explanation I think and I hope it’s permitted by the admins. IV air embolism in medical settings is a very rare occurrence and I don’t believe there is any research on cases of air embolism via syringe as opposed to ”positive pressure ventilation” Via a machine.
“ Pulmonary vascular air embolism Is a rare,and almost invariably fatal,complication of positive pressure ventilation.”
thats why I don’t understand why dr bohin mentions “speed” as that’s only relevant to the machines applying constant pressure or small bubbles of air continuously that eventually lead to one big bubble causing the emboli Or blockage That causes the heart attack. i Would be very surprised if dr bohin is suggesting that LL administered the air slowly using a syringe And that’s my issue Along with the likelihood that a smaller than lethal dose could be administered in the first place. 3 to 5 ml per kg of body weight (of air is considered to be a fatal dose. these babies were i Think all under 1.5 kg. I think it’s reasonable to suggest that LL wouldn’t spend more than a few seconds administering the air embolism considering the circumstances of the alleged attacks If guilty.
“He said "either the volume of air [injected] was less, or the volume of air in the circulation got there more slowly, or a combination of the two."
the above quote isn’t applicable in the context of a syringe used to administer a air embolism as it all goes in at once.
“Fatal air embolism has been reported to occur with volumes of 200-300 mL or in volumes ranging from 2 to 5 mL/kg [4,5]”
now the dosage of air would be limited by the size of the syringe as others have said there is a array of sizes to the syringes available on any ward ranging From 3 ml to 50 ml. This is pure speculation on my part but the chances of LL using a small syringe is smaller than that of a larger one and the likelihood that LL administered a dose smaller than half of a 10 ml syringe and smaller than lethal dose is obviously smaller than a larger one, or even if on the off chance used a 3 ml syringe and didn’t pull the plunger the whole way. I find it difficult to believe that LL would have measured the dose If attempting to kill Or that she would have without measuring administered a smaller than lethal dose. It’s such a small amount of air it would be very difficult to not administer a lethal dose.
its reasonable to me to suggest that if a air embolism is administered with a syringe there would be no extended time frame (more than a few seconds) in which it was done Hence the ”speed” is irrelevant. Also the “volume” is seemingly always going to exceed what is considered to be a lethal dose.
“She said there is a treatment for air embolus.”
yes there is but the main one is not specific, it’s just keeping the heart pumping manually in the hope that it shifts the air bubble and moves it away from the artery that’s blocking the hearts blood flow.
“If clinically indicated, commencement of cardiopulmonary resuscitation is warranted. This will continue end-organ perfusion and may promote migration of the air embolus into the smaller pulmonary vessels [
21].”
Air embolism is a rarely encountered but much dreaded complication of surgical procedures that can cause serious harm, including death. Cases that involve the use of endovascular techniques have a higher risk of air embolism; therefore, a heightened awareness ...
www.ncbi.nlm.nih.gov
there are other treatments but in the context of the countess of Chester I don’t think are applicable as nobody would anticipate these events were caused by an administered air embolism And relating to how treatable the other methods were there is a big difference As they fall under the routine checks list.
stomach checks for embolus via ngt.
“The routine aspiration of gastric residuals (GR) is considered standard care for critically ill infants in the neonatal intensive care unit”
The routine aspiration of gastric residuals (GR) is considered standard care for critically ill infants in the neonatal intensive care unit (NICU). Unfortunately, scant information exists regarding the risks and benefits associated with this common procedure. ...
www.ncbi.nlm.nih.gov
I will avoid putting how often blood sugar levels are checked as they are exclusively rare in the charges.
“Other causes of air or gas embolisms
Although uncommon, it's possible to get an air or gas embolism during surgery, some medical procedures, and when ascending to a high altitude.
In hospitals and health centres, care should be taken to prevent air embolisms by:
- removing air from syringes before injections and from intravenous lines before connecting them
- using techniques when inserting and removing catheters and other tubes that minimise the risk of air getting into blood vessels
- closely monitoring patients during surgery to help ensure air bubbles do not form in their blood vessels
Air embolisms caused by surgery, anaesthesia or other medical procedures can be difficult to treat. Treatment is usually needed to support the heart, blood vessels and lungs.
For example, fluids may be used to treat a fall in blood pressure, and oxygen may be given to correct reduced oxygen levels. Treatment in a hyperbaric chamber is occasionally needed in these cases.”
An air or gas embolism is a serious problem that can happen to scuba divers and during some medical procedures. Read about the causes, symptoms and treatments.
www.nhs.uk
this last bit of information is my reason for stating that an air embolism administered via a syringe is much more difficult to treat than otherwise and so perhaps more lethal.
I'm not sure the gaps in time have much relevance, if any, to an analysis of the lethality of the alleged attacks.
I can't think of a reason for the gaps in time that would give benefit to LL's case, for example I can only think of reasons that would lend weight to the prosecution, such as spacing them out would take the heat off her and lessen visibility and suspicion. We know for instance that in July 2015 there are no charges, and during that month there was a lot of talk on the unit, LL took some time off, and baby A's cause of death was due to be announced imminently. Between baby F and baby G there was a gap of five weeks with no charges and we now know that LL wasn't working night shifts during that time.
We also know that there are other very significant gaps with no charges in that year - a month between baby I and baby J, over two months between baby J and baby K, two months between baby K and baby L and two months between baby M and baby N. That equates to roughly 9 months out of 13 with no alleged attacks on babies.
I don't think the overall time span has any bearing on alleged lethality or method, unless you can think of a reason for its relevance that I haven't thought of. So I've done a list of all the alleged incidents/methods, (as best I can with some less than clear reporting in some of the cases from opening speeches), just to get a view of whether it is apparent from the acts alleged that she changed alleged method to reduce the chances of death occurring, and perhaps enable rescue.
Babies in red are the deaths. The methods stated are alleged and unproven at this time.
A – injection of air iv
B – injection of air iv
C – injection of air ngt and/or iv
D – injection of air iv
E – injection of air iv and inflicted trauma to throat
F – insulin poisoning
G – over-feeding + air
G x2 – over-feeding + air + monitor off
H – injection of air iv
H – injection of air not specified where
I – injection of air ngt
I – injection of air ngt – breathing tube dislodged - alarm paused
I – injection of air ngt
I – injection of air ngt
I – injection of air ngt + iv
J – obstruction of airways
K – dislodged breathing tube + alarm paused
L - insulin poisoning increased dose in relation to baby F
M – airway obstruction or injection of air iv
N – injection of air iv
N x2 – air? + inflicted trauma to throat – no alarm
O – injection of air iv + impact trauma to liver
P – injection of air ngt
Q – injection of air + saline ngt
Would you say it is apparent that she allegedly started using less lethal methods? I wouldn't. Babies I and L stand out as cases in point, IMO.
All MOO
perhaps less lethal is the wrong words To use whereas more treatable is more fitting. I would assume they would all be just as lethal if left untreated Whereas the methods aside from intravenous air embolism fall under the treated as standard bracket.
if they are more treatable and LL would know they were does that mean she was”playing with her prey” with an indifference to potentially fatal consequences or were these methods part of a concerted and consistent approach to murdering these babies?
my thinking was that the four fatalities at the start of the alleged attacks might have been due to her inexperience with killing and once she realised how lethal it was changed to a less definitely lethal method.
“I can't think of a reason for the gaps in time that would give benefit to LL's case, for example I can only think of reasons that would lend weight to the prosecution, such as spacing them out would take the heat off her and lessen visibility and suspicion. We know for instance that in July 2015 there are no charges, and during that month there was a lot of talk on the unit, LL took some time off, and baby A's cause of death was due to be announced imminently. Between baby F and baby G there was a gap of five weeks with no charges and we now know that LL wasn't working night shifts during that time”
this is quite a good suggestion And i can give no reason other than potential motive ie to kill or to gain adoration or whatever. Neither of these potential motives would lessen the severity of the charges IMO, both are well beyond the line of evil. She would gain much more adoration without a fatality which could explain the change in method but I totally see why one could think they were changed to disguise the cause of death.
my suggestion is more to point out potential reasons for the majority of fatalities happening at the start of the alleged attacks.
I will also add that the presence of air embolism according to your more complete table indicates IV air embolism being present in 6 out of seven fatalities whereas all the other charges bar one are not fatal indicating an increased lethality of IV air embolism compared to the other alleged methods. 6 out of 22 charges.
I think that’s it, took me ages to get this together, I don’t know how you do it tortoise.
JMO
www.chesterstandard.co.uk
gsy.bailiwickexpress.com
I just don’t think that less than 2 or 3 ml would be administered without measuring the volume.
