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Girl Brain Dead after Tonsillectomy

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EaglesWings21 is a ASN, RN and specializes in Medical Surgical.

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wtbcrna is a MSN, DNP, CRNA and specializes in Anesthesia.

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While I generally don 't think of a tonsillectomy as an emergent thing, I have seen 3 cases ( 2 were adults) where tonsillitis rapidly developed to the extent that the pts had trachs and vented, due to airway obstruction. All three pts were significantly obese and had OSA. Thus, I would suspect that if the pt had frequent tonsil / throat infections, that a tonsillectomy would more of a necessary procedure than an elective procedure.

That is still an elective procedure. You can treat tonsillitis non-surgically in most every circumstance.

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add to that the increase in cortisol from the stress of the apnea, increasing appetite.

I know this isn't a weight loss thread, but making a 13 yr old do ANYTHING they don't want to do is next to impossible.

I have a daughter who has been obese for most of her life. I tried everything to help her lose weight when she was a teenager, short of locking up every piece of edible material. I even considered locking the cabinets and the fridge. Even if I did that, there's food at school, at neighbors houses, family members, and friends.

Then factor in trying to make them be more active. You can't MAKE another person exercise. I even tried to do that.

Obese>airway obstruction>sleep apnea>daytime lethargy>no exercise>obesity

It truly is a cycle.

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14,620 Posts; 103,255 Profile Views

I don't understand why the hospital won't give the family the copy of the medical records...? Are California laws different than other states? If the attorney for the family is saying that the hospital won't give them the medical record copies so they can take them to an independant dr (which likely wouldn't do anything, but I just don't see why they can't if that's what they want to do), then they must not be releasing them, which I find bizarre.

Hospital records are typically managed (including release of records) through the HIM department, or whatever we've renamed Medical Records these days, and, therefore, records are not released until the person has been discharged and the medical record for that hospital stay is complete, has been sent to HIM, and formally filed. Since this unfortunate girl is apparently still in the hospital, being maintained on life support re: the court order, her medical record is not available to be released. I've worked in a lot of hospitals over the years, and I've never worked anywhere that would release a medical record while the person was still in the hospital and being treated.

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Caffeine_IV has 7 years experience and specializes in LTC, med/surg, hospice.

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An article I read said she also had adenoids remove and excess tissue in the nose and throat removed. So this was a little more complex than tonsillectomy.

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wanderlust99 has 10 years experience and specializes in ICU/PACU.

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I hate how it's spinned into the nurses shrugged it off. Obviously if the patient was in the ICU receiving multiple transfusions, they weren't shrugging it off. I'm sure there's so much more to the story it's hard to formulate an opinion on it.

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JeanettePNP has 8 years experience as a MSN, RN, NP and specializes in Pediatric Pulmonology and Allergy.

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http://www.mercurynews.com/breaking-news/ci_24777699/tonsillectomy-sleep-apnea-critic-calls-spike-surgeries-national

Dr. David Goodman, professor of pediatrics at Dartmouth's school of medicine, is a leading critic of tonsillectomies, and points to Jahi's case as an illustration of the problem.

"What gives me concern is she's a 13-year-old child, and that's an example of the population we know virtually nothing about (concerning) the value of the procedure," Goodman said. "It doesn't mean it's not valuable, but we know nothing about it."

There's been only one randomized clinical trial studying the use of tonsillectomies in treating sleep disorders, but Goodman said it only looked at children ages 5 to 9.

"I would describe it as a national embarrassment that with over a half-century of having tonsillectomies often used, it's irrational that we still don't have high-quality evidence that children benefit from the procedure," he said.

Deaths are rare, according to studies, with mortality rates between 1 in 16,000 to 1 in 35,000 in the 1970s (there are no current estimates). With more than a half million procedures each year, the odds point to occasional tragedies.

"There will be mortalities each year in the country for this operation," Tunkel said.

Goodman called the surgery spike a "unique American phenomenon," and not a good one.

"It's worth noting there are virtually no tonsillectomies done for sleep apnea in England," he said.

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Emergent has 25 years experience.

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Years ago I took care of a 17 yr old homecare trache pt who had had a stroke during a tonsillectomy , thanks to some mistake by anesthesia.

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JeanettePNP has 8 years experience as a MSN, RN, NP and specializes in Pediatric Pulmonology and Allergy.

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There is no surgery that has a 100% success error-free rate. The more surgeries are done, the more tragic cases there will be, even if the overall percentage of errors is low.

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Years ago I took care of a 17 yr old homecare trache pt who had had a stroke during a tonsillectomy , thanks to some mistake by anesthesia.

Really? What exactly did anesthesia do to cause the stroke? And, do you know this for a fact, or are you just repeating what you were told by the family?

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Emergent has 25 years experience.

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Really? What exactly did anesthesia do to cause the stroke? And, do you know this for a fact, or are you just repeating what you were told by the family?

The girl won a lawsuit, something about a needle that nicked a nerve or blood vessel, this was years ago. She mostly recovered and is now a checker in a local grocery store, and has two healthy children.

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KelRN215 has 10 years experience as a BSN, RN and specializes in Pedi.

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Judge orders California teen who was declared brain dead off life support, but family can appeal | Fox Newsust to follow up a court appointed doctor said she is brain dead and the judge has ruled that she is to be taken off life support. the family has until December 30th to file an appeal.

The quotes from the family in that article and this one: Calif. judge: Brain-dead teen can be taken off life support - CBS News are disturbing and reveal a whole new level of denial/delusion. They're going to continuing fighting until she "wakes up" or try to transfer her to another facility? She's not going to wake up and no facility is going to accept the transfer of a brain dead child on a vent knowing that they will never be paid for her admission. The CBS article says that the grandmother is an RN. I realize it's different when it's your own family but come on. The family is grieving but it's time for the child to be at peace.

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