LADIES AND GENTS AND NONBINARY PALS, I SIT CORRECTED.
I would stand, but I am too stunned to keep my feet.
Lovely reader @yourcouragetothestickingplace was kind enough in the comments to ask, “What about Lazarus Syndrome?”
Confused, I blinked at my monitor. Lazarus? Like the guy from the Bible?
Pretty much exactly like that. Okay, the three (four?) days thing is a bit hyperbolic, but this does seem to happen.
This is an extremely rare, extremely WTF syndrome in which someone suffers a cardiac arrest, people attempt to resuscitate them, and that resuscitation fails. The person has no pulse, has no electrical activity, is just…. stone cold dead. So, like sensible persons, the team stops, and pronounces the patient dead.
For some reason that is completely unexplained, the person then gets a pulse back a few
daysminutes later. (Thanks to those who pointed out the typo!!) Some of these people die in the next few days; some go on to live healthy normal lives. There have been 38 cases reported in the literature.The return of circulation seems to happen within 10 minutes in most cases.
This isn’t just a bullshit [Wikipedia piece]. There’s an [actual PubMed article] talking about this.
To whit:
Hey there nonny! Sorry to say, this isn’t a realistic scenario with modern medicine. At least in the ER, patients aren’t declared dead without an EKG (electrical activity), multiple pulse checks, rounds of medication, and a cardiac ultrasound which will let doctors see the heart move, or not.
ERs don’t pronounce people dead unless they’re well and truly dead.
In the hospital, rapid response teams will do everything except the ultrasound, but it’s still just… not going to happen. And in the field, EMS use clinical signs of death: rigor mortis, dependent lividity (blood pooling).
The only way this is going to happen is possibly in a nursing home, on a patient with a DNR order, and even then it’s almost impossible.
Sorry about the lack of drama, nonny, but I’m not sorry that we don’t have people wake up in morgues on the regular.
xoxo, Aunt Scripty
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for Free! 10 BS “Medical” Tropes that Need to Die TODAY!ROSC [Return of Spontaneous Circulation – Scripty] occurred within 10 minutes of stopping CPR in 82% of cases (23 out of 28 patients), with a mean delay of 7-8 minutes. The time taken for ROSC is unknown in 10 patients. Three of these patients were only found to be alive (one in the mortuary) after being left unattended for several minutes, and in seven the data was unavailable from the case reports.2,5,9,12,18,28 However, the time interval could only be an approximation because patients were not always closely monitored following termination of CPR, with a few exceptions.16 …
Seventeen patients (45%) achieved good neurological recovery following ROSC. Three of these patients subsequently died during their hospital stay due to sepsis and pulmonary embolism and 14 (35%) were eventually discharged home with no significant neurological sequelae.
Seventeen patients (45%) did not achieve neurological recovery following ROSC and died soon after. The outcome is not known in four patients (10%). There was no significant correlation between the outcome and duration of CPR, time interval for ROSC or the diagnosis.
You guys, I am literally now questioning every cardiac arrest I’ve ever pronounced. While there are only 38 cases reported, it’s very likely that this is under-reported.
The mechanism by which this works is unclear; one proposed method is that because we blow a lot of air into the chest during an arrest, pressure rises, the increased pressure stops venous return, and the person can’t fill their heart. They enter asystole, we call it, and we leave them alone. The air leaks out, and blood flow returns to the heart – and the heart starts again.
This is especially supported by the fact that the average time to ROSC after cessation of CPR is less than 10 minutes.
I will legitimately be checking my corpses much much better in the future. I had literally no idea the human body could do this, and it has never-not-once been mentioned in my education. I thought this was a holdover from the old tropes of vampires and grave bells, because we used to be really bad at telling when death had happened. Apparently we (me?) still are.
I’m going to go sit in a corner now and contemplate what even is death.
Seriously, thanks again to @yourcouragetothestickingplace for mentioning this.
xoxo, Aunt Scripty
Oh wow, when did this get notes?
