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What to Do If Anoxic Brain Injuries Happen in the Hospital

— December 13, 2018

Anoxic brain injuries can be debilitating, even deadly. Yet, they are most often preventable in a hospital setting if the patient receives proper care.

You may have several concerns if you or a loved one is hospitalized. Typically, the risk of developing a brain injury while in the hospital is not one of those concerns. Anoxic brain injuries (ABIs) are not injuries that are expected to occur in a hospital setting. In most cases, when ABIs do happen to patients while under the care of hospital staff, the cause was preventable.

Here, you will learn:

  • what an ABI is,
  • why ABIs that occur in the hospital are not “normal” or unavoidable,
  • and why you should always get legal help if you or your loved one suffers from an ABI while hospitalized.

How Do Brain Injuries Happen?

There are many different types of brain injuries. Each has a number of potential causes, including:

  • Cardiac insufficiency
  • Respiratory insufficiency
  • Trauma
  • Infection
  • Any combination of the above

This article will focus specifically on anoxic brain injuries (ABIs), which occur when the brain’s oxygen supply is severely restricted. Hypoxia refers to low, restricted amounts of oxygen, while anoxia means no oxygen at all.

Health professionals sometimes use the terms cerebral hypoxia, cerebral anoxia, and hypoxic-anoxic injury (HAI) interchangeably to refer to ABI.

How Do Hypoxia and Anoxia Affect the Brain?

The brain only accounts for 2% of a person’s body weight but uses 20% of the body’s oxygen supply. Like all cells, brain cells need oxygen in order to complete their functions. However, brain cells are unique because they require more oxygen than other cells. This makes them highly sensitive to a lack of oxygen. Even within the brain itself, some specific areas are more sensitive to hypoxia than others.

A brain cell’s job is to communicate with the rest of the body. Without oxygen, brain cells cannot send critically important messages that regulate bodily functions and behaviors. After several minutes without oxygen, brain cells begin to die.

What Causes Anoxia?

The most common causes of anoxia that could occur in a hospital include:

  • Stroke
  • Respiratory arrest
  • Electrical shock
  • Heart attack
  • Heart arrhythmia (irregular heartbeat)
  • Limited oxygen at birth, possibly due to a cord around a baby’s neck
  • Very low blood pressure
  • Carbon monoxide poisoning
  • Other types of poisoning
  • Choking
  • Near-drowning
  • Closure of the trachea (windpipe)
  • Suffocation
  • Complications of general anesthesia

    Hospital room with monitoring equipment; image by Swapnil Acharya, via
    Hospital room with monitoring equipment; image by Swapnil Acharya, via

Some of the aforementioned causes, such as strokes and heart attacks, are reasonably plausible events that could occur naturally and without warning, even when hospitalized. However, hospitalized patients’ vital signs are monitored by staff and machines so that events such as these can be treated emergently if they do happen.

If your loved one experienced an ABI and survived, it is clear that he or she eventually received life-saving treatment. However, to have been hypoxic or anoxic long enough to develop an ABI may indicate that the treatment received was not timely enough.

How Long Can the Brain Last Without Oxygen Before Injury Occurs?

Generally, the brain must be without oxygen for a certain amount of time – usually at least 4 minutes – in order for permanent ABI to develop. After 4 minutes, brain cells begin to die off, and some level of injury is likely to occur.

ABI can begin to occur after 5 minutes with low-to-no oxygen. Once ABI sets in, the likelihood of permanent and severe brain damage begins to increase.

As a protective mechanism, the body attempts to respond to unexpected changes in oxygen availability quickly. In conditions of low oxygen, the body’s initial response is to increase heart rate to deliver more blood, and therefore more oxygen, through the body.

If this attempted solution is unsuccessful and the body still lacks oxygen, the heart rate will slow down to a rate less than the normal heart rate. This leads to a decrease in blood pressure and subsequent shock.

Once the body is in shock (characterized primarily by dangerously low blood pressure), there still remains a period of time where proper oxygen levels can be restored without permanent brain injury.

How Is Hypoxia Treated in a Hospital Setting?

In a hospital setting, treatment for any event that leads to hypoxia, such as a stroke or heart attack, is expected to be emergent. When a patient’s oxygen levels are low, the standard is that he or she will receive treatment as quickly as possible to avoid significant damage and poor outcomes.

While patients are in intensive care units (ICUs) and step-down units, they are connected to machines and devices for continuous vital sign monitoring. A pulse oximeter is one such monitoring device. The pulse oximeter is attached to a finger or toe, and an alarm sounds if the patient’s oxygen levels drop too low.

Because this monitoring is routine on such units, the standard is that drops in oxygen levels can be and must be rectified quickly before the onset of brain injury. For a patient to progress to the point of ABI, which would take at minimum 5 minutes with limited or no oxygen at all, suggests possible negligence by medical staff.

What Are the Outcomes of ABIs?

The outcomes of severe ABI are often dire and may include coma, persistent vegetative state (PVS), and death. Severe ABIs are rare because many people who experience anoxia to this extent do not survive.

People who have had a mild anoxic brain injury are more likely to fully, or at least partially, recover. In many mild cases, the most common symptom is memory impairment. However, other symptoms of mild ABI may include:

  • impaired motor function
  • impaired executive function (self-regulation and self-control)
  • visual defects
  • language deficits
  • learning disabilities

How Do I Get Legal Help for My Anoxic Brain Injury Case?

Legal help is critical for investigating your case, establishing liability, and proving that damages are due. In addition to the mental and emotional trauma associated with a loved one developing an ABI, it can be expensive to provide adequate care for them moving forward. Cost of rehabilitation alone can quickly exceed hundreds of thousands of dollars.

If your case is in Texas or New Mexico the attorneys at Hampton & King can help go over information with you.

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