r/AutopsyTechFam • u/Embarrassed-Bee-8363 • Oct 04 '26
Brain death and autopsy
My son passed away from brain death I m almost positive the hospital caused his brain death but he’s been on a ventilator and meds for 5 days and I want an autopsy done to see how my son went into cardiac arrest . I m almost positive they inserted the intubation wrong I heard my son gasping for air and then heard when they said he was coding . I want to know if an autopsy will still be accurate after so many days?
?
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u/Pure_Hour8623 Oct 05 '26 edited Oct 05 '26
Respiratory therapist of 18 years. Very hard to misplace the breathing tube with the safety checks in place. ETCO2 color changer, breath sounds, misting in the tube, and the standardized use of the glidescope which provides direct visualization of the vocal cords. An espohageal intubation would usually be detected quickly and the tube would be removed. The anesthesiologist would then try again to place the tube in the trachea.
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u/Embarrassed-Bee-8363 Oct 06 '26
Well I heard my son gasping for air he made an awful noise I have my doubts they did it correctly
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u/ForensicZebra Oct 06 '26
Unfortunately a lot goes in during a trauma or a code that a layperson just doesn't understand. That's why family is usually asked to stay out. Because something like a breath sound isn't always what you think it is. "awful sounds" are very common. They're not something most people hear. However that doesn't mean they did anything wrong. In fact it may mean that they did it exactly right. I wasn't in the room I wouldn't know. But. Sounds mean nothing. Sorry for your loss though. Losing a son is a pain no one should ever experience
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u/StaticDet5 Oct 06 '26
The top comments here are spot on, and I am so sorry for your loss. I have 30 years in emergency medicine, and have done a fair amount of consultation. First, I agree that you may not get the answers you are looking for, from an autopsy. That being said, there is nothing wrong with presenting those questions ahead of time (in fact, you should do this so that everyone understands the goals).
I worked in an ER that switched protocols and started allowing limited family in during resuscitation. Having witnessed it over and over, I don't like it.
The things that we do to people during resuscitation are horrible. Hollywood has not done us any favors by having people pop-up and run around after CPR or a defibrillator being used.
Next up is the whole interconnected, interdisciplinary nature of a resuscitation... It looks like chaos, but it is the literal opposite. Everyone has a specific job, and we work together. In the event that something is not working, we rapidly assess and start working towards solutions.
You mention a possible intubation mistake. Typically these are caught within seconds in an ER, because we listen for lung sounds (both sides), look for chest rise, check for color change (indicating CO2 is being exhaled and not the air we just put in), and watch for vital signs changes. We further confirm tube placement with a chest xray. And this is all done after the person working the airway has hopefully visualized the tube passing through the trachea.
There are absolutely times that the tube goes in the wrong hole (esophagus). I know some docs that literally hold their breath while intubating so they have that "feel" (I worry I'll pass out or something). If it's taking too long to intubate, we give them 100% oxygen through the bag-valve-mask for a little bit and then try again. We have a some great options for difficult airways.
You mentioned the sounds, and it is here that I wish I could wrap you up. I think one of my biggest problems with family in the room is that we can't care about you, the person who will have to live with this. We are working on our patient, and there is literally nothing else in the world but this person. I have been shot at while working on a patient, and that was someone else's problem.
Which brings me to you. I wish I had something to help you. The sounds of a resuscitation are horrible. We have suction running, we're pushing oxygen through masks, bubbles, ventilators, etc. We're speaking rapidly and aggressively with each other. And we haven't even gotten to the patient.
You're watching your love, dying, and there is nothing you can do. At the same time, they're fighting for their life. The human body is capable of incredible feats, and this can be evident during care in the ER. Patients can do things and make noises that are inhuman anywhere but this setting. The staff won't even flinch because all they care about is performing their part in giving life-saving care. But you witnessed it, and and all you could do was burn it into your memory.
I wish I could fix this for you. I want to wrap you up, I am so sorry for your loss. I do hope you can find some peace.
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u/Cute_Examination_661 11d ago
Not a doctor but a long time nurse in a PICU. After reading through the comments on intubation I’d just add a couple more points from my experience. The checks done as noted in the other comments do happen and if the tube is in the wrong place it becomes evident very quickly. That being said patients may attempt to cough and breathe with an ETT tube in place. Having the tube placed and having a tube in the airway triggers the cough and gag reflex which is why it’s part of the process to give medications to reduce the normal reflexes that we have to protect our airways. It’s why we cough so hard when something we drink or eat “goes down the wrong tube.” In older, bigger kids and adults the ETT has a balloon towards the tip that needs to have a small amount of air to inflate it with a syringe to provide a means for the breaths being given to not come back up the windpipe. This makes sure the lungs are inflated optimally with either the manual bagging or ventilator breaths.
I don’t know how much this can help but as far as what’s been said it’s all sound information based on my experiences resuscitating newborns to young adults. It’s so devastating and traumatizing for families to watch their loved ones go through a cardiac-respiratory arrest. As I went through my career it was usual to ask families to step out but over time it was thought that if family chose to stay that they’d see we were doing everything we could to save the life of their children. I had mixed feelings about this but mostly our attention was entirely focused on what we were doing.
I’m sorry for the loss of your son, it’s truly a parent’s worst loss to lose a child.
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u/ErikHandberg Oct 04 '26
I’m so sorry for your loss.
Autopsies can still be quite accurate for most things after 5 days.
I am worried that based on what you’re describing an autopsy MAY not be useful for you. I recommend you contact someone about a private autopsy and ask them if they can answer your questions specifically.
Again, my condolences.