Yes, but correct me if I am wrong, the trial has so far only covered the agreed points? So when the prosecution present their case, much more may come out that has not been agreed by the defence?
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I saw a post from a statistician Richard D Gill who talks about this. He was involved in the acquittal of Lucia De Berk. Basically he says once a medical team have it in their heads foul play is involved they become biased and their evidence is not reliable in a lot of cases. Prosecution said there was a 1 in 348 million chance of Lucia De Berk being present at all the natural deaths when they did further independent statistical analysis that went down to 1 in 48. I believe he's involved in LLs case.
Possibly and maybe why the medics on shift didn't think of it but a pathologist would be aware of an air embolism and that it's a risk associated with the procedure carried out just an hour before the crash so you'd think they would have explored it.
Ok, got it now! Actually I don’t know.
Saying that, if child A had a ‘trophic’ 1ml feed I would think it would be given via an ng tube.
It’s likely these babies would have both ng tubes and IV lines. I would think.
It is called confirmation bias - tunnel vision, not considering other possibilities
You always want access to a vein with patients receiving treatment, most patients on most wards in a hospital will have a cannula of some sort. I've never worked with premature babies but I've known a few and they've always had NGs so I imagine that's commonly placed with neonates too. I'm sure someone with more knowledge can clarify but I'd assume most if not all of the babies would have both an NG and cannula in place, at least to begin with.
I have never come across air embolism (air injected into the bloodstream) as a cause of death in a neonate. I have, however, sadly come across death on many occasions with no definitive cause, and it is put down to prematurity.
Very early in my training I was taught by nurses senior to me the dangers of air embolism, and the importance of zero bubbles in central lines and infusions. So although not everything is seen in practice, the knowledge of risk is there. If you are administering anything into a baby's bloodstream, you surely know of the dangers of air embolism.
So would say it’s likely that both would be accessible the vast majority of the time?
This is true. Even if they aren't getting any milk for whatever reason, an NG tube is in place to drain built up stomach acid or built up air. Cannula or a long line until they reach full feeds and don't need fluids anymore.
Would you say it’s easy to spot once it’s occurred? Before or after death?
Would there be any reason as to why the her shift change hasn’t come up in more detail in terms of when it was. Surely it can’t be disputed?
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I would say it is extremely difficult to spot, and that nurses are pedantic about introducing even the tiniest bubble into a baby's bloodstream. I would also think it's difficult to determine as a cause of death in a post mortem, because often there is air in the system anyway from a vigorous resus
. Which is why I can't understand how they've come to this decision in so many of the babies retrospectively, and I'm interested to hear the medical evidence. Baby would either be gasping or breathing very fast, pulse would be fast but weak, blood pressure drops... very non-specific symptoms that can be explained by other things. I think the cases for air embolism will be the most difficult for the prosecution to prove.
But why? Why do birthdays and graduations need to be advertised in a newspaper? To a bunch of strangers.....?
From what I gather from the very poor reporting on the case, the cannula ‘tissued’ (failed) so had to be taken out, they tried to insert the UVCs which you can’t use without confirming its in the right place with an xray, these were both in the wrong place so a long line was inserted. All of these take time cause of the actual procedure of inserting the lines as well as the whole needing to xray them all before use etc. So typically when you’ve got a baby thats difficult to get access for IV fluids in, you’d put an NGT down to their stomach and start giving feeds just to make sure they get some sort of fluid in and to make sure their blood glucose level doesnt drop whilst awaiting IV access. So from that I’d say there wasnt both bloodstream access and NGT access until LL came on and started the 10% dextrose at 8pm after they’d confirmed the long line was in the right place. NGTs are really easy to insert and easy to ensure they’re in the right place so once thats in you wouldn’t really take it out. So from what I can gather there was stomach access only for a few hours, then from 8pm there was bloodstream and stomach access.
Please. He got Lucia de Berk off and now thinks every single case of a nurse being prosecuted is the same. The man is as biased as any of the doctors/prosecutors he speaks of - and has his own agenda in promoting that case on every single forum.
Good question to ask him is - how many convictions of murderers has he managed to overturn compared to the 1000s around the world that have been correctly sent to prison. Also Lucia's case fell apart, not just because the statistics were wrong but the prosecution made serious errors in her whereabouts - having her attending to patients when she was on holiday etc. There wasn't the digital footprint we have now back then. For everytime statistics has been wrong, many more times it's been correct.
Also he's not involved in LL's case because the Dutch legal system and investigation is very very very different to the UK. He self promotes very well.
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I really don’t understand the discussion behind this, it’s not an abnormal thing to do at all and is in no way relevant to the case. Can we stop?
I'm not sure why you find this so odd. Births/Deaths and Marriages have been announced in local newspapers (and national newspapers if from 'society') since the 1700s, and before that a town crier would read out announcements. It's a societal norm, or was until social media evolved.
It feels like the prosecution is laying out the agreed facts today like you would in a financial/fraud case and no one today has had reason to accuse LL of doing anything or not doing anything- they’ve just been saying what they did and how they felt. I suppose, in some way, they (may) have been defrauded, except this isn’t missing money it’s attacks on life and a trusted and respected colleague not being who you thought they were.
If you were trying to show that someone had been stealing money, but didn’t have actual proof of them with their hand in the petty cash, it would be expected in a trail for everyone else near it to give an account of where they were and what they were doing. And if someone said ‘I wasn’t sure at the time if it was actually my fault because I wasn’t sure if I locked up properly, but I’ve looked at the cctv footage and I did, and now I teach other people to lock up, and these days, with all my experience, I wouldnt have second guessed myself when I thought we were £10 under because I’m really good at keeping a tab on the petty cash tin…’
I’ve gone off on a tangent, but you get my drift.
At this stage of the proceedings we are still picture building. No one has had a bad word to say about LL (save the fact we are hearing all this at a murder trial) because no one has been asked to comment on that, and the hospital did make mistakes- no one is disputing that. But the death of poor little baby A and the collapse on baby B is still unexplained at the moment. We (the jury) will have to make a decision as to whether it was deliberate rather than being the fluids, the cannulas, the UVC, the temperature not being recorded, the doctor not being as experienced as we’d have liked him to be, birth complications, the discolouration/not discolouration. The prosecution haven’t really laid out how they got to their conclusion yet.
If you were trying to show that someone had been stealing money, but didn’t have actual proof of them with their hand in the petty cash, it would be expected in a trail for everyone else near it to give an account of where they were and what they were doing. And if someone said ‘I wasn’t sure at the time if it was actually my fault because I wasn’t sure if I locked up properly, but I’ve looked at the cctv footage and I did, and now I teach other people to lock up, and these days, with all my experience, I wouldnt have second guessed myself when I thought we were £10 under because I’m really good at keeping a tab on the petty cash tin…’
I’ve gone off on a tangent, but you get my drift.
At this stage of the proceedings we are still picture building. No one has had a bad word to say about LL (save the fact we are hearing all this at a murder trial) because no one has been asked to comment on that, and the hospital did make mistakes- no one is disputing that. But the death of poor little baby A and the collapse on baby B is still unexplained at the moment. We (the jury) will have to make a decision as to whether it was deliberate rather than being the fluids, the cannulas, the UVC, the temperature not being recorded, the doctor not being as experienced as we’d have liked him to be, birth complications, the discolouration/not discolouration. The prosecution haven’t really laid out how they got to their conclusion yet.
I still need to catch up on the last 10 pages but my thoughts and questions so far from today:
*The baby would have been out of the incubator for a long time during the several attempts to get IV access. Therefore, personally I would have checked the temperature more often as babies find it difficult to regulate their own temperature.
*My main concern about having no fluids for 4 hours would be the risk of baby's glucose levels dropping. I'm guessing they were checking babies sugars frequently during this time
*Urine output-during the procedures to gain access I'm guessing the lines were flushed (with 0.9% Saline) countless time to see if they worked therefore baby could have more fluid onboard if that makes sense.
*what the doctor thinks now about the placement of the longline should not even be considered should it? What he thought at that time would be more important wouldn't it?
*I think many nursing and medical errors are going to be flagged up in this trial and will hopefully result in a huge overhaul in neonatal and children's nursing.
Can I just ask?
Is room 1-Intensive Care (ICU)
Room 2- High Dependancy Unit (HDU)
Room 3-Special Care Baby Unit (SCBU)
Room 4-The nursery
*The baby would have been out of the incubator for a long time during the several attempts to get IV access. Therefore, personally I would have checked the temperature more often as babies find it difficult to regulate their own temperature.
*My main concern about having no fluids for 4 hours would be the risk of baby's glucose levels dropping. I'm guessing they were checking babies sugars frequently during this time
*Urine output-during the procedures to gain access I'm guessing the lines were flushed (with 0.9% Saline) countless time to see if they worked therefore baby could have more fluid onboard if that makes sense.
*what the doctor thinks now about the placement of the longline should not even be considered should it? What he thought at that time would be more important wouldn't it?
*I think many nursing and medical errors are going to be flagged up in this trial and will hopefully result in a huge overhaul in neonatal and children's nursing.
Can I just ask?
Is room 1-Intensive Care (ICU)
Room 2- High Dependancy Unit (HDU)
Room 3-Special Care Baby Unit (SCBU)
Room 4-The nursery
I really appreciated the person who a while ago who said how uncomfortable they were on following all this. I feel the same. I’ve been thinking about it a lot and the conclusion I’ve reached is that my life is a bit crappy atm (I’m sure it is for many people). Things have felt relentless out in the world since 2016. I really feel for the families of the babies, those poor babies themselves and for all the people having their lives disrupted in real life by all of this. But, hiding behind my screen, I really appreciate this thread. I’ve used my brain in ways I haven’t for ages and I feel connected to something when everything else feels so disconnected.
The whole idea of a nurse doing something like this is bonkers and isn’t how things shouldn’t be and just trying to make a little bit of sense of it, however much of a dubious coping mechanism for my life this may be, feels… I dont know… helpful to me at this moment in time. So thanks everyone. I really value hearing about peoples experiences and expertise. I like the different ways people think. Some of you are really funny too.
Nb. I do realise that this is a very real case and there is so much pain in what happened and what’s happening xx
The whole idea of a nurse doing something like this is bonkers and isn’t how things shouldn’t be and just trying to make a little bit of sense of it, however much of a dubious coping mechanism for my life this may be, feels… I dont know… helpful to me at this moment in time. So thanks everyone. I really value hearing about peoples experiences and expertise. I like the different ways people think. Some of you are really funny too.
Nb. I do realise that this is a very real case and there is so much pain in what happened and what’s happening xx
Why did the royal stastical society release a report a week or so before this went to trial ? A bit much of a coincidence ?
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