Lazarus Reflex

[Medico]

Has anyone ever seen this? I learned of this today and it is fascinating to me.

This is a involuntary reflex that everyone has. Apparently it is only seen when there is brain death and stimulation to the spinal cord or the pt is removed from the vent.

http://www.youtube.com/watch?v=Nty6bICZlyA


http://en.m.wikipedia.org/wiki/Lazarus_sign

 

[Medico]

This isn't new to anybody else?

 

[Maine iac]

Pretty cool. Hadn't heard of that before.

 

[Pneumothorax]

Been around a few expired patients and I've never seen this or heard about it. Pretty cool! I'll keep an eye out for it!

 

[Medic Tim]

I will be looking for this now

 

[EpiEMS]

Well, that was sufficiently awesome

That was very cool!

 

[Speedylifsavr]

Great post...thanks for sharing!

 

[Meursault]

Very interesting. It's unfortunate that it's just one more thing families can use to delude themselves, though.

 

[Underoath87]

So you just have to tilt the head forward?

Hmm...I'll have to try this next time I have an IFT vegetable to freak out my partner.

 

[TB 3541]

That's pretty cool.

 

[NomadicMedic]

So you just have to tilt the head forward?

Hmm...I'll have to try this next time I have an IFT vegetable to freak out my partner.

Nice post. I'm sure you're truly a caring provider.

 

[Underoath87]

Nice post. I'm sure you're truly a caring provider.

I do my job and get my patients safely from point A to point B as comfortably as possible. I could just as easily try to sound self-important and say that it is in the name of science, as that surgeon in the video is doing, and it wouldn't make any difference to the patient or anyone else (besides maybe someone browsing this forum who has too much time on their hands and likes to get offended over inconsequential things).

 

[Amberlamps916]

I know someone at work who is going to try this on the 25+ mechanically ventilated/braindead patients who receive dialysis that we transport daily.

 

[firetender]

Why are you running that call?

It's most likely the way you'd find this out is by accident.*

Since it's basically a short-circuit in the nervous system it could also happen with other, seemingly unrelated, bodily manipulations.

Stuff like this happens sometimes spontaneously with NO stimulus. I've had a patient who had been comatose like this for FOUR YEARS suddenly and out of nowhere throw a fist at me and growl! It was like the DVD catalogue of movements he once made skipped to this action and fired off. His body played it out, and then returned quickly back to its comfortable state of Limbo. **

As far as manipulating your patient's bodies to see if you can produce the Lazurus Effect: Consider if that is in your job description and what someone observing it might report. Then consider if that is the link you want to be in that patient's "chain of survival".

First comes the patient. It doesn't matter if you decide he/she is alive in a dead body or dead in an alive body, he/she is under your care.

* in which case the poop will be scared out of you!
** in which case the poop was scared out of ME!

 

[NomadicMedic]

I do my job and get my patients safely from point A to point B as comfortably as possible. I could just as easily try to sound self-important and say that it is in the name of science, as that surgeon in the video is doing, and it wouldn't make any difference to the patient or anyone else (besides maybe someone browsing this forum who has too much time on their hands and likes to get offended over inconsequential things).

Whatever dude. You're the person that referred to your patient as "an IFT vegetable" and thought it would be "cool" to "freak out" your partner by manipulating their body.

You should think before you post.

 

[Meursault]

Nice post. I'm sure you're truly a caring provider.

Burnett's Law, modified, is now in effect. All persons intending to post are advised that this thread may be unsalvageable and quality posting help will not be available if trolling is encountered.

 

[JakeEMTP]

I know someone at work who is going to try this on the 25+ mechanically ventilated/braindead patients who receive dialysis that we transport daily.

Brain death and vegetative are two very different things.


A patient who meets that criteria of brain death will not be transported for dialysis by you. It will be a struggle to keep them alive for just 2 or 3 days until their organs taken for the procurement process or until the family or doctor ends life support. If the patient requires dialysis, even the type done in ICUs, chances are there will be no organ procurement team involved.

I also can not imagine where you are that you are transporting ventilator patients for dialysis and especially at those numbers. Usually those patients are in an LTACH which has inhouse dialysis. Could you possibly offer more information about this? Is this a CCT truck? Barlow is the only facility that I can think of around here but I thought they did their own dialysis.

 

[Amberlamps916]

You're right about my choice of description for the patients. That being said, I know of multiple facilities that do dialysis on vegetative patients. My company has 25+ patients who go 3 days a week, accompanied by a Respiratory therapist. Most of these patients are in full on vegetative mode. I wouldn't be surprised if some of them didn't even need dialysis. Nonetheless, it is an extreme cash cow for companies to charge for these kind of CCT transports. Numerous dialysis facilities accept these kind of patients, I'm sure it's not really advertised though.

 

[JakeEMTP]

You're right about my choice of description for the patients. That being said, I know of multiple facilities that do dialysis on vegetative patients. My company has 25+ patients who go 3 days a week, accompanied by a Respiratory therapist. Most of these patients are in full on vegetative mode. I wouldn't be surprised if some of them didn't even need dialysis. Nonetheless, it is an extreme cash cow for companies to charge for these kind of CCT transports. Numerous dialysis facilities accept these kind of patients, I'm sure it's not really advertised though.

What is the history of these patients? If they are on mechanical ventilation, they must have significant diseases. Dialysis is not just something you do for the heck of it and saying the doctors are sending them for a surgical shunt and then dialysis 3 times a week for no reason is a pretty serious accusation. It sounds like you don't believe these patients deserve care or have no respect for them. Even if these patients are DNRs, that does not mean you don't treat or make comfortable. Sometimes discontinuing care is a difficult thing for families and sometimes a patient might appear to be vegetative but are just locked in which is about the worst thing that could happen to them. They would hear every word you are saying about them and can do nothing. The offering of dialysis is a big deal for some facilities both good and bad although it is great if the patient does not have to be transported out which is always a big risk. There is no shame in dialysis and is a needed service. Withholding treatment from every patient who requires dialysis would be a major decision and I doubt if the United States is ready for that yet.

Also, once a patient goes into long term care, the fee is negotiated with rates according to Medical, Medicare A or B, or the private insurance. It is an income but not exactly a golden egg.