Archie Battersbee case

[whynotwhatknot]

I was just wondering why we're not allowed to post about this case-the deletion message mentioned it was ongoing so wouldnt be fair to the family

Charlie gards case was on going and there was numerous threads about it

Anyway if this stands maybe we can discuss

Not medical but I thought being on a ventilator included oxygen and you couldn't be on a ventilator without it, especially if the patient is brain dead and not making any attempt to breathe by themselves. Mind you my son was on cpap on air, no oxygen and I didn't really understand how that worked either.

No, you don't always ventilate with oxygen. It can be done on room air, particularly if he's just having pressure support. But I'm very rusty on ventilator settings. But I would read that as he's beginning to struggle. Especially if he's been on stable settings for weeks. His brain must have got to the point that it's so decomposed that the heart will not function soon.

How long can a brain dead person be ventilated?
What gives out in the end? Do they succumb to infection, or do they have a cardiac arrest?
I have read about a 4 year boy who was brain dead and kept on life support for 20 years.
The autopsy findings make for very grim reading.

I'm guessing that whatever benefit Archie's body derives from breathing, it gets it just as well on room air as it would on oxygen.

It's interesting that she's acknowledging that it's a fight for him to be kept going (even if she gives the credit to Archie rather than the doctors and nurses) which is quite strikingly at odds with the army's constant proclamations that he'll wake up and jump out of bed any day now. In her heart of hearts she is acknowledging the reality that sadly he isn't going to come out of this.

Think of the ventilator as a big pair of bellows. It has multiple modes, so it can just breathe in and out to a set pressure, volume, and rate, it also has other modes where you can just set it to breathe in, to a set pressure limit, or to a set volume of air. it depends on why the patient is being ventilated. sometimes they need high pressures, sometimes they need high rates, and sometimes they need lots of oxygen. it varies depending on the reason for being ventilated.
In Archies case, he has no lung damage (if he has no infection). So what he needs is the physical breathing in and out, because the brain stem controls breathing and that's now dead, he has no ability to breathe by himself.
He won't need oxygen unless he gets an infection, he won't need high pressures, he will just need a normal rate and the ventilator to breathe in and out for him.
Unfortunately, ventilation has a side effect. it can actually cause lung damage, and because the tube goes directly into his lungs and he can't cough then he is also at increased risk of infection, which in itself causes further lung damage.

Not medical but I thought being on a ventilator included oxygen and you couldn't be on a ventilator without it

If the reason for being on a ventilator is because the lungs are impaired, maybe through infection, or because getting oxygen to the whole body is a problem, like with shock, then oxygen will be required.

However, Archie is on a ventilator because his brain stem is dead, so his respiratory drive has gone. His lungs are fine (for now) but the machine needs to simulate breathing movements because he can’t make them anymore.

Thanks for the info about ventilators. Hollie has posted that someone at the hospital made a mistake with the ventilator and if she hasn't noticed Archie wouldn't still be alive

Grief is a terrible thing.

I hope his body gives out soon, this is just undignified.

Thankyou for the explanation about ventilators. All my medical knowledge comes from 5 weeks in the nicu and many years of watching casualty so there is a lot I don't understand. Doesn't help when the "army" are spouting absolute crap.

Mind you my son was on cpap on air, no oxygen and I didn't really understand how that worked either

CPAP provides positive end expiratory pressure but the baby is doing all of the breathing movements. My simple way is understanding it is that, at the end of expiration, the lungs deflate and then there’s muscular effort to inflate them. CPAP gives additional breathing support and means that, at the end of breathing out, the airways are residually more “open” so it takes less effort for the baby to breathe in.

The pressure is usually the last thing to be weaned. So, in the case of a premature baby with hyaline membrane disease due to immaturity, CPAP with oxygen could be used if the baby was working moderately hard, and acceptable saturations couldn’t be maintained just on air (inflamed lungs, baby struggling to breathe). As the baby gets better, or if the lungs weren’t that bad to begin with, they just need the pressure support, so CPAP without oxygen.

If the baby is at risk of tiring because they are still working to breath on CPAP, and/or the oxygen support keeps climbing, then the baby is intubated and ventilated to let the ventilator do the work for them. Unlike Archie though, this is because the lungs are problematic (usually immature). The baby CAN breathe but the lungs aren’t healthy enough to oxygenate the body.

There was a rage on there over another story which is recent. Girl in hopsital declared brain dead,mum not believing. Cries of how can this happen from the army and Archies mum and something needs to change and the whole wanting organ story.

Sadly she has now by independent doctor been declared brain dead and mum is switching the life support off as no chance of recovery...

I saw that
The people in these armies are incapable of independent thinking
Back in the early days of the pandemic, there were concerns whether there were enough ventilators for all those people who needed them ,and in the very beginning we didn't know how badly children would be affected
Thankfully it never came yo Dr,s having to choose which patient would get a ventilator ,and most children were only mildly affected by COVID, but its not to much of a reach to think there could have been a scenario, where someone who did need a ventilator couldn't have one because it was essentially being used to keep and a dead person artificially alive .

I've just looked at insta on the purple army hashtag. It's so sad. I hope that wee lad's body gives up soon, because this is beyond the stuff of science fiction. Keeping a body warm with no end point in sight? Oh, it's just so cruel for everyone who loved him.

I hope his parents get some support to help them accept the tragic outcome of their son's accident. And I'm choosing to believe that it was an accident.

I read a post by one of the ‘army’ that said he’s in an induced coma, is that true? I thought that wasn’t the case.

He's Brain dead according to all the medical reports
The "Army" haven't a clue what they are talking about.

Recent post by his mother (on an essex echo facebook article). It's a terrible state of affairs that she's still convinced this is true. As others have said, shame on the lawyers/experts/army of strangers who are enabling and encouraging a grieving woman. Wishing her and her family peace, I hope she is able to hear what the NHS staff are telling her.

Hollie Dance
We all know the court will go in favour of the hospital, its a stage show but facts are only way to pronounce death is heart and brain stem test . The law is not an MRI . The mri child has 9 bottom teeth. No vent tube down throat. Nurses confirmed Archie has 12 bottom but no evidence is allowed to be put in from us lol . Why ? Why have we not been allowed a independent doctor not connected to The Royal london ? Why was I not allowed private blood test day they was GOING to do brain stem test but couldn't? To many questions unanswered why was another child's medical records put in Archies medical records? 🤔 just a few questions that won't be answered on this court case but let's keep allowing the system to get away with these things and hope no one else has to through this 👍

Meant to say, "experts"....

She thinks the hospital are swapping another child's MRI for her sons? Oh dear. I'm sympathetic, but curious about why no one is able to communicate the reality of the situation to her.

I'm guessing because she probably won't listen, she's convinced herself Archie will get better and anybody who says he won't just wants him dead,I'm a mother I can empathise with her ,nobody wants their young child to die in those circumstances, but sadly that's what's happened somehow she has to accept that

Sorry if I’m being dense @nolongersurprised but what are the implications of this?:

A healthy child’s heart rate has a lot of beat-to-beat variability. The time between beats isn’t fixed, it changes with breathing but presumably also in response to other nervous system stimuli. A child’s ECG, if the machine is adult calibrated, will often come with the report of “sinus arrthymia” because of this. Archie’s heart beat tracing on the monitor looks like a metronome

I think the PP was basically saying that HR fluctuates naturally in response to stimuli and physiological changes in the body. This is controlled by the brain communicating with the heart via the nervous & endocrine system.

The heart will carry on beating even if the brain is seriously damaged or non-functional, as it is myogenic, but you no longer see heartrate variability.

Yes.

And I think sadly she has thousands of people agreeing with her, including family members and the laywers who are representing her. I imagine she isn't able to engage with anyone who saying the opposite.

Sorry if I’m being dense @nolongersurprised but what are the implications of this?

@pinkred has answered better than I would have!

it just really highlighted to me - visually - that they are are ventilating a dead body. It must be so hard for the medical stalk looking after them.

With regard to the MRIs, I remember in the High Court trans script, after Hollie claimed the images weren’t his, that a doctor sat with her and went through the images sequentially, highlighting that each image had hhs details.

Ive said it before but I think she’s delusional at the moment. Projecting life onto a corpse because she so desperately doesn’t want it to be true. I’m not being disparaging of her mental health, I, and many of us, I’m sure, would be at risk of a severe mental health episode if our child was found hanged and essentially dead.

The grief vultures, by encouraging her though, are making everything worse for her in the long run.

The ventilator changes mentioned upthread are a bit strange, no need to change the settings. There are settings that are breath activated, so the patient starts to breathe, then the ventilator assists. But that wouldn’t work for Archie because he hasn’t made any breathing movements so far.

It might be clearer on Monday

Not true, no. The army members remain convinced that he is in a coma. Hollie is coming out with more and more outlandish claims about the hospital and it's staff all the time now and the army members hang off every word and egg her on, talking about organ harvesting and all the rest of it.