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Here is the text I'm having trouble with (from Foundations of Legal Research and Writing 5th Edition by Bast and Hawkins):

To their horror, they saw two bodies in the deep end of the pool. They all jumped into the pool and pulled out the bodies. The two women tried to revive Joseph and Phil while the two men called the police and fire departments. When they arrived, the police and firefighters joined the Andersons and the Cookes in trying to revive the two boys. The two boys were rushed to the hospital but died a few hours later.

A few hours later? Is that plausible (realistic)?

  • Actual death and announced dead are not the same. Hospital will try revival methods. – paparazzo Dec 1 '17 at 21:31
  • @Paparazzi - The text doesn't say "but were pronounced dead a few hours later." (I could swallow that.) It says "but died a few hours later." – aparente001 Dec 1 '17 at 21:36
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    @aparente001 Simply a common misuse of the words by journalists and authors. (And I don't understand the downvote.) – Carey Gregory Dec 2 '17 at 2:09
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    It does seem very odd to me that they don't say "pronounced dead a few hours later" but rather that they "died a few hours later." Maybe just bad writing? I disagree with Carey that it is "very realistic" that they were still alive hours after they got to the hospital. Pronounced dead is more likely. – omikes Dec 3 '17 at 11:07
  • Most likely they still had beating hearts, but pulmonary edema and electrolyte disturbances made it impossible to keep them alive. – Graham Chiu Dec 3 '17 at 19:39
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As far as I know it depends on how much damage it has been done to the brain firstly and the other organs. Usually the first cells to die in the brain are those located in hypotalamus and they start dying within 3 minutes and as the lack of oxygen progresses other brain cells die to.

The last important organ that is heart starts dying at 15 minutes. So probably if you rescue the person now and start CPR it will live but with brain damage(the worst here being a vegetative state due to major brain damage).

Also another big factor in cell death is the metabolic rate of cells which slows down considerably in very cold water temp. In my uni Emergency book it is said that people could stay drowmed in cold water for up to 45 m and live.

I hope my answer helped you, but I'm pretty sure you can find a ER professional healthcare staff around here which will provide way better answe than this.

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    I don’t have much to add to that. Maybe you can just quote your Emergency book and give a source, and point out that the victims were dead once (drowned), resuscitated and died (most likely) from the consequences of the cardiac arrest and weren’t able to be revived then. But a solid answer, +1 from me – Narusan Dec 1 '17 at 20:40
  • @Narusan-sedated and Kermilli, can you spell out for me how long the whole process might take? To my eye, that "died a few hours later" looks strange. If a child or teen is taken lifeless from the water, and does not respond to the first responders' attempts to resuscitate, but then does respond to the ER staff's efforts, what's the most amount of time that might go by between pulling from the water, and successfully getting revived? Can it really be several hours? – aparente001 Dec 1 '17 at 21:34
  • @aparente001 The way I understand the story is that locals on scene were able to resuscitate the patient, but the patient died later nonetheless due to other consequences. – Narusan Dec 1 '17 at 21:35
  • @Narusan-sedated - I guess it's the glass half empty or half full. I take "trying to revive the two boys" to mean they weren't having much luck. – aparente001 Dec 1 '17 at 21:37
  • Well, if you get someone out of the water lifeless, they are already (clinically) dead because their heart stopped beating for sure. So for them to die later on, they must have come back to life - in my understanding. CPR is not performed for hours until the patient is pronounced dead. – Narusan Dec 1 '17 at 21:38
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Yes, it's very realistic.

The boys were apparently clinically dead when found. Clinical death means there is no pulse or respirations. Clinical death is not necessarily permanent. CPR, defibrillators, and drugs can sometimes reverse the situation.

Clinical death is different from legal death, which is what happens when a doctor declares someone dead.

The most likely scenario is pulses were never restored, but they were young and previously healthy so a lot of time and effort was expended trying to resuscitate them. It was quite possibly a few hours.

This is a very common scenario. When you read that someone was taken to the hospital in cardiac arrest and died hours (not days) later, what that usually means is the hospital spent hours trying to save them but failed. They most likely never regained pulses. The time of death is reported when the doctor in charge gave up and declared them dead, not when their hearts stopped.

  • Thanks -- this is helpful. // Instead of "If you're going to drown, do it in salt water," don't you mean, "If you're going to run into trouble in the water, do it in salt water"? // Note that the text doesn't say anything about pulse or respiration. Also note that the four adults may be assumed to not have any special expertise with medicine or emergency response. They can't be relied upon to correctly perceive pulse or respiration -- they haven't had the training, and also they're busy freaking out. – aparente001 Dec 2 '17 at 2:36
  • Carey, can you spell out for me how long the whole process might take? If a child or teen is taken apparently lifeless from the water, and does not respond to the first responders' attempts to resuscitate, but then does respond to the ER staff's efforts, what's the most amount of time that might go by between pulling from the water, and successfully getting revived? – aparente001 Dec 2 '17 at 2:40
  • @aparente001 You're asking additional questions that are impossible to answer. That's not what comments are for. Ask a new question. – Carey Gregory Dec 2 '17 at 5:20
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    Let me try to be clearer. In your "edit," you wrote, "apparently rescuers were able to restore pulses." WE DON'T KNOW THAT. That is an unfair assumption. – aparente001 Dec 2 '17 at 5:26
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    @Narusan-sedated In the US the usual practice is for paramedics to provide three rounds of ACLS at the scene, and if a heartbeat isn't restored that's it. The patient is dead. But with pediatric patients and arrest due to drowning, a lot more effort is going to be made. I've never seen a pediatric patient left at the scene except in extreme trauma cases where clearly nothing can be done. Who knows what happened at the hospital. Maybe they got pulses restored but lost them again. Spending hours is unusual. – Carey Gregory Dec 2 '17 at 17:22

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