The Archie Battersbee case

[Boring Monday]

I'd like to know which idiot was going to donate it to them... Then get home and realise they couldn't breathe!

It’s not like they’re calibrated for each individual either, is it.
Take 70 year old Uncle Ken’s CPAP, give it a bus ride, trundle it across a car park, sneak it past a dozen or so policeman, a ride in a lift … it’s not going to be any use to Uncle Ken anymore let alone an infant.

 

[Cack Conroe]

Forgive me for being stupid, what was the situation with the brain stem testing (BST) that meant he couldn't be tested? I thought originally they didn't agree with it so the hospital had to gain permission to go ahead and do the testing, and then when they did the testing 'Archie failed on one area'. What did he fail and how? I'm not understanding that bit.

From my experience (sorry to keep referring to it, but it's so close which is why this case is interesting me) BST should take place >6 from the loss of the last brain stem reflex (so this could be a cough, triggering the ventilator, blinking, etc), electrolytes and vital signs must be within range (as much as able given the patients condition), and the patient should be clear of all sedative, muscle relaxing and opiate medications. BST is then undertaken by two senior clinicians and is done slowly, thoroughly and in numerous stages. And then repeated for clarity.

All of the cranial nerves are then tested. So light shone into pupils to test reactivity, ice water syringed into ears to test vestibulo-ocular reflex, gag and coughing tested, reaction to pain is tested with more pain then we would usually use in day to day/hourly assessments, doll's eyes response, and more. All sounds cruel but it is vital and necessary. And then the apnoea test is undertaken, which yes does mean coming off the ventilator for a short period of time, to see if they breath spontaneously, but is mostly about testing CO2. The patient is monitored throughout, pre-oxygenated beforehand and has a bagging circuit attached to their ETT/trachy so they can receive manual breaths if they become compromised.

Anyway, I've gone way off my question. Which bit is the poor boy said to have failed? I'm just curious, because if he 'failed' any of the BST then it may be his brain stem was marginally in tact at the time, but 'passing' 90% of the test is hardly a big win and paints a pretty grim picture - and by now, this many weeks on, I imagine what little he did have of his brain stem has been completely compressed and has gone?

The peripheral nerve test gave no response at all, so the brain stem test was abandoned as this can give a false negative result.

How long can somebody survive if
their brainstem is gone? I know nothing about this type of nursing as I was only a care home nurse. What are the processes involved in keeping his heart beating?

There’s a case here of a boy whose brain completely died at age 4, he was kept on a ventilator for a further 20 years. After he kept getting pneumonia, his mother finally decided to pull the plug.

Warning, contains autopsy images of the calcified brain and is generally gruesome reading:

https://hods.org/pdf/Long%20Survival%20Following%20Baterial%20Meningits-Associated%20Brain%20Destruction1.pdf

 

[karmadrama]

This is just disgusting now. People really are so delusional to think that Archie is just going to wake up and prove the doctors wrong.

I know people have said that his mum is only fighting for the right to let him ‘die’ the way she wants him to and that she understands it will happen either way but she wants it to be natural. So if that’s the case why is she allowing people on the Facebook group to talk about Archie waking up and getting better etc.

Surely in that position you would ask them to stop with all the false hope. Or does she really believe he’ll wake up as well?

 

[bubbadabut]

This is just disgusting now. People really are so delusional to think that Archie is just going to wake up and prove the doctors wrong.

I know people have said that his mum is only fighting for the right to let him ‘die’ the way she wants him to and that she understands it will happen either way but she wants it to be natural. So if that’s the case why is she allowing people on the Facebook group to talk about Archie waking up and getting better etc.

Surely in that position you would ask them to stop with all the false hope. Or does she really believe he’ll wake up as well?

I just saw a post about it on the Sky News FB page. I thought the comments there might be a little more balanced, but no. Rational people were overwhelmingly outnumbered. No common sense, no nuance, no critical thinking, no mental capacity for forming a coherent argument. People who do possess those attributes are seen as a threat to them, hence the distrust of the medical professionals.

 

[super grateful]

The peripheral nerve test gave no response at all, so the brain stem test was abandoned as this can give a false negative result.

But this is quite confusing. That’s a “pass” on BST. If there were a response then you’d question if his brain stem were intact and therefore “alive”, but no response signifies that it likely isn’t therefore that’s the go ahead to continue with the rest of the test.

 

[Leascarle]

But this is quite confusing. That’s a “pass” on BST. If there were a response then you’d question if his brain stem were intact and therefore “alive”, but no response signifies that it likely isn’t therefore that’s the go ahead to continue with the rest of the test.

see this is the bit I don’t understand

 

[acsunderland]

This is just disgusting now. People really are so delusional to think that Archie is just going to wake up and prove the doctors wrong.

I know people have said that his mum is only fighting for the right to let him ‘die’ the way she wants him to and that she understands it will happen either way but she wants it to be natural. So if that’s the case why is she allowing people on the Facebook group to talk about Archie waking up and getting better etc.

Surely in that position you would ask them to stop with all the false hope. Or does she really believe he’ll wake up as well?

I’m sorry but natural would mean no machines No?

 

[sheleg]

To all the medics and HCPs on here, I honestly salute you for your knowledge and experience.

 

[KittyGhosts]

This is an interesting read about the Christian Law Centre and their dodgy claims of qualifications

On the Naughty Step - the questionable ethics of the Christian Legal Centre - Nearly Legal: Housing Law News and Comment

Some people will not have come across the Christian Legal Centre (CLC) until the Alfie Evans case. Others will know something of their history. What the Alfie Evans case has done is cast light on what one might call the modus operandi of the CLC and some serious and pressing questions about the...

nearlylegal.co.uk

 

[Rosie glow]

Has anybody seen the clip where archie supposedly squeezed him mums hand? I haven't seen it but I was talking to someone yesterday who said you you can clearly see him moving his hand. We debated for a while the person I was talking to seeing it from a mothers veiw and me seeing it from a medical point of veiw. Was interesting to see it from another veiw point as I'm not a mother.

 

[stevenseagull]

Squeeze the pads on your hand. Your fingers move involuntarily.
Bodies can also move of their own accord.

This has been discounted by medical professionals, the same way she’s claiming his eyes are open and crying.

His eyelids are swelling and his eyeballs are dry so they have to put regular drops in.

The same way she claims his hair is still growing so he can’t be dead.

She’s so seriously delusional that it’s cruel no one is helping her come to terms with this.

 

[veevee04]

Hollie dance (the mother) is very dodgy apparently legally changed her name from Lisa Pittaway has convictions for assault and ABH. Has previous form for running to the papers when things don't go her way, there's a FB group talking about it all. There's definitely something weird going about the whole thing. I think the hospital should sue her for slander imagine being accused of murder when you are literally caring for a corpse.

The Archie's army and all the other Armies have an IQ of a goldfish.

 

[bubbadabut]

Hollie dance (the mother) is very dodgy apparently legally changed her name from Lisa Pittaway has convictions for assault and ABH. Has previous form for running to the papers when things don't go her way, there's a FB group talking about it all. There's definitely something weird going about the whole thing. I think the hospital should sue her for slander imagine being accused of murder when you are literally caring for a corpse.

The Archie's army and all the other Armies have an IQ of a goldfish.

It's a sad indictment of society that so many people are like this. At least in my neck of the woods. I come from a very rough area of the UK and can well believe a large proportion of the population around here would be on the side of the Army. I know people have said it's not a class issue but it's definitely an intelligence issue, which ties in with poorer social standards and educational outcomes in working class areas. Imagine that lot doing jury service or similar "He did it your honour, I can feel in in my water and our Shelley always said he was a wrong 'un".

 

[kittenattack]

Has anybody seen the clip where archie supposedly squeezed him mums hand? I haven't seen it but I was talking to someone yesterday who said you you can clearly see him moving his hand. We debated for a while the person I was talking to seeing it from a mothers veiw and me seeing it from a medical point of veiw. Was interesting to see it from another veiw point as I'm not a mother.

Relatives and non medical people constantly misinterpret bodily signs and signals. Wishful thinking in most cases. I got a shock the first time I laid out a dead body as a young student. The thing let out a big sigh as I turned it over and nearly dropped it as a result

 

[BeansOnBeans]

Unfortunately this is going to be a case that has no winners in the end. The outcome is the same, there is no blood flow to the brain and the stem is actively decaying, his organs will be slowly deteriorating, clinicians feel that his death was likely back in April.

The family should be using this time to be by his bedside, not in the media and doing tv interviews and harping on about gofundmes and hobbycraft bracelets.

 

[FoxyBingo]

A distant in law shared the article regarding the case yesterday and said something along the lines of "yes Archie, keep fighting, more time to wake up" and I thought it absolutely alarming that there are so many people out there who literally do not understand that this poor boy is dead. Too many people like this giving the family the ammunition they need to carry on, all whilst the poor boy lie there decaying, and the poor staff being slandered try their best to carry on.

What do the family see as the end result?

 

[WeepingCassandra]

A distant in law shared the article regarding the case yesterday and said something along the lines of "yes Archie, keep fighting, more time to wake up" and I thought it absolutely alarming that there are so many people out there who literally do not understand that this poor boy is dead. Too many people like this giving the family the ammunition they need to carry on, all whilst the poor boy lie there decaying, and the poor staff being slandered try their best to carry on.

What do the family see as the end result?

I genuinely think that a high percentage of them believe at some point he’ll slowly open his eyes, gasp a little, they’ll take all the tubes and bits out and within ten minutes he’ll be sat upright chatting away like nothings happened. Medical dramas on tv have a lot to answer for in this context.

 

[kittenattack]

Low IQ combined with inadequate education results in this behaviour. People just have no concept of how bodies work. I agree about the TV and movies as well. They're fantasy levels of inaccurate, but these people believe this is how things work. Sadly, it's causing untold suffering to patients and staff in cases like this up and down the country.

 

[Weeder]

I seriously thought telling the twats he had zero blood flow to the brain would wake them up, but apparently perfusion is for weaklings

 

[stevenseagull]

I think the concept of a child dying is just too horrific for many people to deal with. They would rather buy those tatty bracelets they are selling and pretend he’s going to be ok than face the facts that children do and will die.