British woman revived after six-hour cardiac arrest
bbc.com
bbc.com
> Once her body temperature had reached 30C, they used a defibrillator to jump-start her heart some six hours after emergency services were contacted.
> Mrs Schoeman was released from hospital 12 days later, with only some lingering issues with the mobility and sensitivity of her hands due to the hypothermia.
> How long her heart stopped for is not clear - she may still have had some circulation, although not detectable.
Provides a constant flow of oxygenated blood which allows for higher endurance, longer "holding of breath", and in the case of severe injury, oxygenated blood circulation to prevent death (unless there is catastrophic blood loss which moots the machine's ability)....
Recall all the famous designs of Cyborgs [and The Borg] with the tubes running into their face/head/nose - the tubes could be pumping externally oxygenated blood to the vitals which would suffer most in catastrophic physical unplanned destruction events.
In his case, the lungs are still working, but there's no scientific reason we don't have cyborg lungs yet.
Had. The article is from 2011; according to Wikipedia "On March 24, 2012, Cheney underwent a heart transplant procedure", "he remained alive without a pulse for nearly fifteen months." source: https://en.wikipedia.org/wiki/Dick_Cheney#Health_problems
I am convinced that Cheney is the reason Barnaby Jack was murdered.
Jack knew how to remotely attack pacemakers, as well as pumps and other medical devices and was to speak at BlackHat... but was neutralized just days prior...
/Tinfoil
Once back in the late 40's to for fighter pilots, and again in the 90's, a practice they called "Blood loading".
Also, such a system would likely require giant cannulae placed in rather inconvenient places, e.g., the neck, thigh, or chest, as in ECMO. That would limit movement significantly.
“Nobody is dead until warm and dead”: Prolonged resuscitation is warranted in arrested hypothermic victims also in remote areas – A retrospective study from northern Norway
J. Hilmo, T. Naesheim, M. Gilbert https://www.sciencedirect.com/science/article/pii/S030095721... (open access, CC licence)
Same hospital and team that treated Anna Bågenholm (mentioned in other comments, https://en.wikipedia.org/wiki/Anna_B%C3%A5genholm), and I guess that case is part of the study.
[1] This is known as "targeted temperature management" (TTM), and is part of the standard post-ROSC (return of spontaneous circulation) algorithm in ACLS (Advanced Cardiac Life Support), if you're looking for terms to Google.
What you might want to do is to cool the brain through cooling the outside of the head as well as through the nasal cavity.
Even if you chug a giant slurpee the largest effect on the brain temperature will be the cooling of the nasal cavity on it's way down.
We're talking about a naked, sedated patient (so they're already losing a lot of heat due to simple convection, and there's no heat being generated by skeletal muscle movements). The body's metabolism has slowed significantly, and it's producing anywhere near the normal level of "baseline" heat.
Afaik interest has been low in carrying around enough ice pack capacity to make this viable, and with lacking data for it even working, whereas head-cooling packs with circulating liquid through a cooler takes little space, cools way more efficiently and required no other maintenance after insertion into the patient in the ambulance (and is moved with the patient while continously working).
seems like a bold claim to me.
Because creating a cooling system to use on a body with a central nervous system fighting to keep it warm is just like central HVAC.
And yet, something as simple as ice cold water seems to work fine for this. You can cool e.g. even a heatstroke victim pretty quickly, without worrying too much about internal thermoregulation.
A heat stroke victim the body is fighting to cool itself and failing. You assist. That part is easy.
Getting the body to do the opposite of what you want is the hard part. ie. Cool down below basal body temperature, stop breathing to perform thoracic surgery.
It's exciting stuff, but it's definitely not widespread.
- The headline is clickbait/false really. The six-hour cardiac arrest is pretty much made up/guessed. In fact, they don't know how long she was in cardiac arrest. The article actually goes on to state "how long her heart stopped for is not clear", so it's a bit odd to say she had a six-hour cardiac arrest.
- The six hours timeframe actually refers to the fact that a defibrillator was used 6 hours after the emergency services were called.
- It mentions that doctors are stating it's the longest cardiac arrest ever recorded in Spain. This is a very odd thing for a professional doctor to do, when they have no evidence to back that up. As a doctor, you can't just guess she was in cardiac arrest for 6 hours and record it down as being what happend. That's misleading information.
Children do better.
The mammalian diving reflex prepares the body for long periods of immersion. Not to be relied upon.
It is the struggling and adrenaline that causes rapid loss of consciousnesses in water, as it rapidly depletes oxygen and works against the reflex. If one calms themselves and uses deliberate movement 5 minutes is achievable in 2-3 months of training in tropical waters, by an individual in average health.
When we spearfish we don't race to the bottom or rocket to the top, we use a lazy peddling motion to slowly decent and ascend. It helps in preservation of oxygen, once on bottom we usually hover in one spot, and try to remain still while almost meditating. We only move while actively hunting a particular fish once spotted. While the reflex is active your mind can work with the reflex to help it shut systems down and focus blood to the brain which is what it is doing. Each movement reactivates a system, eating before a dive activates a system, not using the restroom before a dive can leave a system active (though the reflex generally tries to shut that down by increasing the urge as soon as you enter the water, hence the have to pee when you get in the pool reflex).
While I hatted it, I experienced the same thing as you did: I could hold breath for a minute out of water and 2:08 underwater. There's the preparation, getting calm and relaxed, but there's also the diving reflex playing some part there and preparing your body for longer immersion.
https://en.wikipedia.org/wiki/Anna_Bågenholm
The electrocardiogram connected to her showed no signs of life,[2] but Gilbert knew patients should be "warmed up before you declare them dead".[25]
https://web.archive.org/web/20191206164443/http://www.leapbe...
If you've never taken a CPR course, sign up for one! It could save a life one day.
Apparently he noticed that equally injured soldiers would die at different times based upon how close they were to the camp fire with those closest expiring way before those laid out the farthest from the fire.
Could be a bs story, I never actually looked into it.
If I was rich enough I'd host a competition to extend the life of rats: Each year, whoever could demonstrate a technique to reliably extend the lifespan of a rat by at least 10% over the previous year's record would win a million dollars. I expect that the wining entry would involve putting the rats into controlled hypothermia.
Over the years the maximum lifespan will grow and we may even find that we can put rats into hibernation indefinitely. It would then be a question of whether we can apply the same techniques to humans.
Hypothermia due to a low environmental temperature has already been flagged as the way to come out of various otherwise fatal situations in more or less one piece. Besides that, even if no pulse can be detected that doesn't mean there isn't a pulse, and that can make all the difference just by itself.
https://www.bbc.com/news/health-11389464
Just the fantasy of the life-extenders that if they figure out this one weird thing they will live forever. The body can be temporarily suspended, depending on the complexity of the creature this can be a very long time, frogs for instance can do it for weeks or even months.
https://www.latimes.com/science/sciencenow/la-sci-sn-alaskan...
The big differentiator is whether or not the water in the cells has crystallized or not, if it does it will rupture the cells and then it is game over no matter what. Other than that it is mostly a roulette game with very high stakes.
There are lots of papers on frost damage to cells, too many to list here but easily searchable.
Basically, no. Not that we know of yet anyway. This is more of a 'stars aligning' story and her being lucky not to have the bad side effects of her situation. The bad side effects happen more times than not in this sort of thing. Death or brain damage.
Something quite close to this is being done for mice. The Methuselah Foundation awards cash prizes for (1) 'the longest-living mouse' and (2) the longest-living 'rejuvenated' mouse, i.e. you have to design a treatment that works for 'old' mice, extending their life as much as possible.
Here's an article about Aubrey de Grey, the guy behind the Methuselah Foundation award: https://thenextweb.com/contributors/2018/09/19/aubrey-de-gre...
you'd get more from calorie restriction.
https://www.iflscience.com/health-and-medicine/child-survive...
There are a few such known examples, also some that looked good for a while but ended with a tragedy as much as a day later. I can see some parallels with the drowning case due to the hypothermia, the onset of which must have been relatively fast.
Another recent example of one of our rock star doctors involving the successful reattachment of a severed hand without blood flow for 10 hours.
https://www.thinkspain.com/news-spain/30483/super-surgeon-dr...
Early open heart surgery was pioneered with TWO patients whose circulatory systems were connected together so that patient two could could breathe and pump blood for patient one while the heart was stopped.
Amazing (in a sort of blank-faced-blink-blink sort of way)
I.e. is the state of your brain preserved just by the connections of the neurons? Or is the "RAM" also critical?
Very important difference.
There are cases of people without short term memory. That to me qualifies as RAM, guess its not critical to survival.
The connections between the neurons is the architecture. The neurons themselves have state. If that state is wiped across the brain, I'd be surprised if the body connected to it could even still keep itself alive.
To the actual question though, neurons die/fail very quickly at their normal metabolic rate without an oxygen supply. You are certainly dead once that happens.
These procedures are all about providing some oxygen and dropping the metabolic rate to keep the neurons alive longer than they would unassisted.
Now I want to read a sci-fi book with this sentence in it.
A key concept in Netflix's cyberpunk series Altered Carbon is the 'stack', an advanced hard drive installed on the brainstem on which a person can save a copy of their consciousness. The main effect of stack technology is a form of immortality, because a stack can be installed into another body if the original body dies. But there’s another a major implication only hinted at during the first season of Altered Carbon: If you could choose your own body, would you go with the one you were born with? That's an especially important question for gender fluid or transgender people. The topic was only hinted at in the first season, but Altered Carbon creator Laeta Kalogridis told The Wrap it's something she would like to explore in greater detail.
https://en.wikipedia.org/wiki/Altered_Carbon_(TV_series)#The...
This would be the perfect research testbed for human psychology and intelligence. Do something, compare with exact but unmodified state.
wow, this is so intriguing. i like this analogy even if i don't know how accurate it is.
we indeed have things that we forget (running out of space?) and things that take time to remember (disk latency).
Like how deleting files doesn't properly wipe out the bits and with the right tools you can still recover deleted info.
If the brain continues its metabolism without oxygen it induces neuronal cell death.
The mechanism is called anoxic depolarization. Sodium–potassium pumps in the cell walls need to work to maintain K+ and Na+ ion gradient. When the pump runs out of energy it causes glutamate and aspartate concentrations inside the cell grow. When they grow past some critical threshold, it starts programmed cell death.
Cooling he body and brain can prevent this when the brain metabolism slows down to match the lower oxygen levels.
That will teach me to make comments before the caffeine has kicked in.
Survival rates:
- Cardiac arrest (outside hospitals): < 6%
- Cardiac arrest (inside hospitals): < 25%
- Heart attack (myocardial infarction): > 90%
"In summary, there is a difference between a heart attack and a cardiac arrest. A heart attack occurs when the blood supply to part of the heart stops and thus causes a section of the heart muscle to begin to die; whereas a cardiac arrest occurs when the heart stops beating as a whole.Jun 25, 2019" [1] https://www.news-medical.net/health/Heart-attack-and-cardiac...
I went to the US on business - our corporate insurance means there's a $1000 excess that we pay up front.
Went to a hospital for a minor issue. At no point was there any price list shown, at the end I was asked for $390 before been given my prescription. That was the end of it I thought, sickeningly high charge for 2 minutes with a doctor, a 10p tablet, and hours of waiting around. I asked for an itemised bill, but they couldn't give me one.
A few weeks later I get another bill through the post for another $390 (slightly different amount), complete with the entire bill. The whole bill was about $2k. The 10p tablet? $250. In fact they originally gave me a 50mg one for $9, then took it off the bill, then gave me 2x25mg ones for $250. I then had a $1100 "uninsured discount" which brought the total price down to just before $800.
The bulk of the bill was a single line that was fairly incomprehensible but seemed to cover pointless taking my blood pressure 3 times and the 2 minute consultation with a Doctor who barely spoke to me, and renting the chair for a few hours I guess.
edit: see http://imgur.com/ERjjQBil.png
The U.S. is seriously broken.
That sounds like straight up fraud. What the hell.
The pricing system is intentionally designed to be opaque so that everyone except the consumer benefits. It is not uncommon for a top surgeon to make 500-750K per year, nurses are paid well above the median and can make over 100K with overtime, hospital administrators, insurance companies... the way pricing and billing is handled protects all those interests.
Sounds like something you would want to fix, right? Well that too is complicated. Healthcare is one of the only sectors that is growing middle class jobs. A hospital is one of the only places someone with an associates degree and a certification can make 60K per year.
Furthermore, it is one of the only growing industries that provides many opportunities for women. Not many women want to move to Montana to frack shale oil.
Start socializing medicine and all that job growth and opportunity disappears.
It is a tough problem to solve. The utter irrationality of it used to drive me nuts and still does sometimes, but I prefer it to the alternatives.
Is this supposed to be a good argument to drive desperate people into bankruptcy?
Personally, I think it's unethical to keep a process inefficient even if the inefficiencies are profitable. And healthcare in the states is anything but cost-efficient.
The fact that the US has many leading medical research institutions is often abused to argue that we have the best care, but it's largely irrelevant for the overwhelming majority of delivered care and even more irrelevant for outcomes.
Pegging growth to systemic inefficiency is monumentally stupid.
This is only a few steps of abstraction away from simply paying those nurses to dig holes then fill them back up, macroeconomically.
I feel like you are making a lot of assumptions about how we would fix our health care system that are unfounded.
Urgent care would have had something closer to a $100 markup than $2,000, because you’re only paying for a few nurses and doctors to be on call, not for having used the resources that are meant for trauma and acute crises.
That hospitals are required make up fictitious itemized explanations for their very real costs is indeed broken, but it’s a very small part of the overall issue.
If you called the hospital billing department and offered 20% of the overall bill, they would likely have immediately accepted; uninsured hospital billing has expected value on the order of 10% of outstanding balances, so if you give them more than they can get from sending you to collections, they’re usually happy to compromise much more steeply than the 60% “discount” they offered you.
Oh yeah, I asked how much I would be charged before the doc saw me and they refused to answer.
$100 markup my arse.
For instance, if you work a lot with tools and dirt then there is a fine line between blood poisoning and a mere scratch, they will both start out the same but you won't be able to tell what's in your bloodstream until it is too late if you're going by symptoms alone. By the time the choice is amputation above or below the knee or you've gone into septic shock you've lost the window where you might have been ok. More people die from this stuff than from heart attacks or strokes.
So in some cases, when the exact contaminant is not known it can be a good decision to go to the hospital to have something looked at, and it shouldn't cost an arm and a leg (pun unfortunately not intended) to do so.
Nobody goes to the hospital for fun except for a very few individuals that have something wrong with their heads rather than with their bodies, and that's before we get into things like people with compromised immune systems.
And yes, I have bandaids.
Urgent cares used to be pretty upfront. I went to an urgent care a couple of years ago, $99 advertised in the window. I go in, fill out all the paperwork and they tell me it's going to be $150. When I point to the window, she says it's expired. I start to walk out and she tells me to come back and gives me price. This is not the only time I've had to walk out over various health things, it's ridiculous. They think you won't do it because you're ill and act that getting angry over this is some sort of insane response. So now I just pretend not to have the extra money.
Anyway, I use Heal now. So happy that the VCs are funding this, hope it lasts.
Just looked up the one near to my hotel. Closes 6PM. Not much use at 2330.
Urgent care can get you antibiotics and test for strep, and I think x-ray and set simple fractures, and stitches of course. What else is within their scope, I find it fairly limited.
It's entirely possible that you're insured, but no facility within an hour's drive will take your plan, and if your kid becomes ill outside of business hours, tough luck. For liability reasons, they'll refer you to the ER anyway if you have symptoms beyond a sore throat.
The last time I had to go to an urgent care clinic in a state where no one took my insurance plan, I had to pay $700 out of pocket to talk with a doctor for 10 minutes and get prescribed a z-pack. I then paid $90 for 6 pills at the pharmacy.
https://news.ycombinator.com/newsguidelines.html
HN has had countless generic arguments about the US health care system. Turning a thread about something else into one of those is a step in the wrong direction. The major controversies eat up all the smaller topics, but the smaller topics are what actually gratify curiosity.
I met the most spiritual woman who was also in a crusade against Abrahamic religions say that
What a completely unfalsifiable version of logic when the “plan” could just as easily be the treatment
I got through the impasse by saying it just gives people choices even if the choice is already written in stone
Schrodinger’s free will