Man dies mid-flight after breaking out in 'cold sweats' and losing 'liters of blood,' scaring his fellow passengers

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Man dies mid-flight after breaking out in 'cold sweats' and losing 'liters of blood,' scaring his fellow passengers
businessinsider.com
  • A 63-year-old man died on a Lufthansa flight on Thursday, according to Swiss-German outlet Blick.
  • Witnesses told the outlet the man had blood gushing from his nose and mouth.
  • The witnesses said passengers were screaming at the sight.
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Critical care nurse here. The answer is esophageal varices.

It's the same physiological anomaly as hemorrhoids, except in your esophagus. Swollen, fragile veins caused by increased internal pressure. In the case of hemorrhoids, that pressure inside the veins is caused by straining too much when trying to poo. In esophageal varices, the increased pressure inside the esophageal veins comes from blood backing up from a swollen, scarred, and damaged liver. So we often see esophageal varices in end stage alcohol use disorder.

Horror stories abound in emergency departments and ICUs of having to do CPR on a patient massively hemorrhaging out of their mouth from esophageal varices. As soon as nurses I know saw this report, our immediate thought was, "Yep, varices."

https://my.clevelandclinic.org/health/diseases/15429-esophageal-varices

I’ll take “Reasons to never drink again for $200, Alex.”

There are a few things I wish we could really show the public. The first is how brutally savage and undignified CPR really is. And the second is what alcohol abuse really does to a person.

Chronic malnutrition, brain damage, hallucinations, anxiety, internal bleeding, fluid swelling your abdomen like a water balloon, literal ammonia building up in your blood that we treat by deliberately inducing massive diarrhea. That's not even mentioning esophageal varices and the increased cancer risk.

Alcohol is a horrifying drug.

I'm a 911 dispatcher, I've talked people through CPR countless times over the phone, I have very little confidence that most of them were doing it properly because CPR really is pretty brutal, I've taken a lot of CPR classes over the years, and every instructor I've ever had has mentioned that if you're doing it right there's a very good chance you're breaking ribs in the process. Unless you've actually had training and have an idea how rough it can be I doubt that most people are going to do it hard enough out of fear of hurting the patient.

I've luckily never had to do CPR in person myself, although I was once on-scene while it was being performed. I was at a party, someone came inside said they think someone died out front, I went out to see what was going on, came around the corner of the driveway and my friend was already doing CPR on a guy laying in the street who crashed his motorcycle. I know my friend also had CPR training so I let him keep at it, I stood by to relieve him in case he got tired and started counting to make sure he was keeping a good rhythm. I of course know my share of cops, firefighters, EMTs, etc. who have had to do CPR in their line of work, but I don't exactly press them for any details about it, but I talked to my friend afterwards to make sure he was OK, and he talked about how he could really feel the guys ribs popping as he was doing it.

It was also a pretty good illustration of the bystander effect, when my friend got outside there was already one or two other people pulled over with the accident but not really doing anything, not checking on the guy, not on the phone with 911, just kind of standing there. If you asked them, I'm sure they probably would have said they were blocking traffic with their vehicles or something, but that doesn't really do any good when the guy needs CPR immediately.

CPR is like blowing into a cartridge game expecting it to work again. It hardly ever works and if it does, it's not going to work next time unless there are some major changes.

That is so utterly wrong. It all depends on the cause of death. Especially sudden traumatic deaths, such as choking or drowning, where the rest of the body was little impaired, have crazy high recovery chances if immediate and persistent CPR is applied.

And even on chronically I'll patients, e.g. the commonly thought of cholesterol caused infarction and subsequent heart attack has a good chance to recover. Modern medicine is amazing!

But in most cases, you simply won't know in the moment why somebody dies. And does it matter? You can make assumptions, but you could be totally wrong. So leave that part to the EMTs and doctors. Your job as a human in that moment is to give someone the best chance they will get to experience more life.

In all cases the chances of survival and recovery sink with literally every second, which is why it can be so frustrating to see people too scared or cynical to even try. What are you afraid of? You can't make em any more dead. And I truly hope anyone would be willing to "waste" the time and effort to at least try if I suddenly died. Even if your CPR is too weak, too strong ( yes, also possible, albeit very rare), too slow or too fast: the by far worst CPR is the one not given at all.

And I can promise you this: you will never regret having attempted to do CPR, even if there is no resuscitation.

I am sorry if I offended you. I wasn't being dismissive of CPR. I actually am certified by the Red Cross for CPR and my mother and sister are nurses. I was under the impression it was a last ditch effort that hardly ever works. And if it does it's usually broken ribs and hard to recover from when they are extremely elderly.

On its own, it has a very low percent chance of recovery. Though it does change based on the mechanism of injury. However, it is extremely useful in prolonging the period in which other medical interventions can be successful. It very much gives time for EMTs to arrive and use defibrillators or chemical intervention.

I'm confident in your training they made it extremely clearly to call 911 and start emergency responders before starting CPR if you are the only person there.

CPR alone usually wont bring someone back, but what it does is buy time for them to get more advanced treatment that might.

There's some exceptions, things like asphyxia and drowning have a pretty decent chance of bringing the person back if it's done properly and promptly. In things like opioid overdoses it can buy you a couple critical minutes for cops or the ambulance to get there and shoot some narcan up their nose and then they're back on their feet in no time flat.

Fun fact: you can get narcan to carry as a first aid measure from almost any pharmacy, and many local health departments host narcan trainings and give it out for free. Giving someone narcan when they don't need it won't do anything at all, so the worst you're doing is nothing, and the best case scenario, you can save a life.

I actually performed CPR during an industrial accident. A contractor was welding at a large power plant, and someone sabotaged the acetylene bottles by opening the valves on 3 cylinders, then torquing the cap on with a pipe wrench. 3 people collapsed from asphyxiation and their entry attendant sounded an alarm, they were pulled out by a few people with SCBA's we kept close by due to confined space entry rules. That right there was the life saver, we drug them out, administered CPR, broke the fuck out of their ribs and they started breathing again.

It was a very lucky scenario for the survivors as they collapsed and received CPR in about 120 seconds.

May I ask what you consider to be alcohol abuse? Yes, there are papers and sites and all that. I tend towards trusting the opinion of people on the ground a bit more.

CDC's take on excessive alcohol

Binge drinking, the most common form of excessive drinking, is defined as consuming

For women, 4 or more drinks during a single occasion. For men, 5 or more drinks during a single occasion.

Heavy drinking is defined as consuming

For women, 8 or more drinks per week. For men, 15 or more drinks per week.

Hospital usually see people on their worse. Friends and family see them on the way to their worse stage.

I'm not sure what you consider to be people on the ground, but one would argue the people publishing peer reviewed research in the field have dedicated a significant part of their lives to that topic and are as "on the ground" as possible when it comes to their area of expertise.

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My wife's aunt died from Cirrhosis of the liver and "so much blood" is exactly what my wife said she saw.

Just another reason I’m glad I don’t care to drink alcohol… did not know this was even a thing 🤢

The only time I see ER docs panics and asked for another ER doc to be on "stand by" for emotional support is when they need to change a leaky Blakemore tube.

You know it’s a been a bad day when you arrive to your shift and the Blakemore box is out…

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