Anne Heche in critical condition following fiery car crash, 5 August 2022

[Gemmie]

CNN has just confirmed that Anne is indeed brain dead but remains on life support as the doctors search for needy organ recipients. Her family made a statement to this effect to CNN.

Interesting. I was wondering why some media was saying she was dead, and why CNN was so behind the ball since they weren't saying it. I checked People and this was what was said (article published today at 2:30pm, whatever time that was (I like to see the timezone so I can do the math for where I live)):

Emmy Award-winning actress Anne Heche has died, PEOPLE has learned. She was 53.

The family's rep confirms to PEOPLE that, while Heche is legally dead according to California law, her heart is still beating and she has not been taken off life support in order to allow OneLegacy Foundation enough time to find recipients who will be a match.

Anne Heche, Star of Another World and Men in Trees, Dies at 53

The death of Anne Heche, an Emmy Award-winning actress and mother of two, comes a week after she crashed her car into a home in Mar Vista, California. Loved ones pay tribute

people.com

 

[Peppery]

What's the Difference Between a Coma and Brain Death?

Answer: A lot.

www.life-source.org

“Brain death is a very conservative diagnosis and is only made when there is no doubt in the findings. Brain death is a rare event that occurs in one out of every 200 hospital deaths (CDC study, 1986).”


“Only after brain death has been confirmed and the time of death noted, can organ donation become a possibility.”

 

[jbc]

Perhaps a MD can give some insight.
The family said that brain death was due to anoxia.

From the helicopter video of the crash, Heche was not unconscious as she was being put into the ambulance.
I'm sure everyone here saw her impulsively sit up in the stretcher before being loaded in.
So, she was not sufficiently anoxic at that time to be unconscious.

So, what happened after?
I can imagine she might have been overwhelmed with infection, inflammation, or other things. Compounded by the ketamine-induced coma that I think I read about. But I do not know.

Does any MD here have thoughts? Thanks!

 

[Peppery]

Perhaps a MD can give some insight.
The family said that brain death was due to anoxia.

From the helicopter video of the crash, Heche was not unconscious as she was being put into the ambulance.
I'm sure everyone here saw her impulsively sit up in the stretcher before being loaded in.
So, she was not sufficiently anoxic at that time to be unconscious.

So, what happened after?
I can imagine she might have been overwhelmed with infection, inflammation, or other things. Compounded by the ketamine-induced coma that I think I read about. But I do not know.

Does any MD here have thoughts? Thanks!

Nurse here, not an MD, but the anoxic brain injury probably didn’t happen when she was in the car. I’d guess she coded while in transport or after arrival at the hospital and it took some time to get her back. Think about performing CPR over burned tissue. Injury to the brain can happen within 3-4 minutes without oxygen. Or depending on her injuries, it may have been very difficult to intubate her or even bag her. With severe burns there is risk of fluid shifting which can cause edema (tissue swelling) and blood flow to her brain could have been affected. Add in the likely smoke inhalation injuries she suffered so her lungs weren’t working as efficiently as they should to exchange oxygen for CO2 in her blood which causes carbon dioxide toxicity and there’s not much that can be done. I think it was CNN that said she slipped into a coma on Monday so I suspect that’s when the brain injury happened. JMO.

ETA-strokes are a huge cause of anoxic brain injuries, so that’s a possibility as well.

 

[gliving]

@jbc I'm not an MD but worked in a health care setting. An anoxic brain injury causes death of brain cells. This causes intercranial swelling which can lead to brain stem herniation. The brain stem is part of the central nervous system that controls vital body functions such as blood pressure regulation, respirations, heart rate, etc.

An early sign of brain injury can be combativeness or agitation which is what we might be seeing with Anne on the stretcher. Her brain is injured from lack of oxygen but swelling is yet to occur. As the swelling progresses, the patient becomes unresponsive and requires life support.

MOO a very simplified explanation of a very complicated event.

 

[BetteDavisEyes]

Anne Heche is brain dead after fiery crash into home, spokesperson says

The 53-year-old actor suffered an "anoxic" brain injury when she crashed her car into a Los Angeles home.

www.nbcnews.com

 

[DeDee]

In my glory days, I was an Operating Room Nurse who was occasionally required to be "on call" for emergencies. When taking a patient into surgery who is an organ donor, they are no longer alive. The organ or organs are removed as quickly as possible. It is a very solemn occasion. The typical noises of the OR are absent. There is no anesthesiologist needed.

Once we have the room set up, the Doctor arrives with his/her donor team. Sterile techniques are observed to prevent contamination so everyone wears sterile gowns and gloves. The surgeon places the organ in an ice chest filled with ice for transportation purposes but most importantly being chilled the organ has less chance of developing bacteria. Organs are only viable for a short amount of times when out of their body so time is of the essence. The donor team would immediately hop on a medical helicopter, with the organs in tow, and fly to the location of the recipient.

What an honor it would be for someone to have Anne's organs.

Here is a link to more info as I've offered a condensed version based on experiences from long ago.

How long can organs stay outside the body before being transplanted?

 

[gliving]

I didn't know organ donation is the default law in CA. Unless you choose not to donate, it's going to happen.

New Law in California Makes Organ Donation Easier - Contra Costa Senior Legal Services

California has taken steps to increase the number of organ donors in the State. On January 1, 2019, A.B. 3211 went into effect. The new law makes three changes to California’s Advanced Health Directive (AHCD) law, which clarify patients' rights regarding organ donation. New Law Simplifies Organ...

www.ccsls.org

The new law simplifies the choice to donate organs and/or tissue by making the choice all inclusive. Donation is now the default, and if a person wishes not to donate, they must say so. Instead of separate questions, the new form has just one choice for those electing to donate. The new language says that upon death, organs, tissue, and parts can be donated for transplantation, therapy, research and education. Individuals can specify exceptions or cross out any of the choices in the general donation clause.

 

[Gemmie]

What's the Difference Between a Coma and Brain Death?

Answer: A lot.

www.life-source.org

“Brain death is a very conservative diagnosis and is only made when there is no doubt in the findings. Brain death is a rare event that occurs in one out of every 200 hospital deaths (CDC study, 1986).”


“Only after brain death has been confirmed and the time of death noted, can organ donation become a possibility.”

OK, really stupid question as I obviously don't know much about these things. Also, a warning this may be a bit morbid. I apologize for that but I'm truly curious about this one fact.

What now if they determine there are organ(s) that they can take for donation? I realize her brain is dead, and according to CA law, she's legally dead. But her heart is still beating. Do they wait for that to stop on its own before taking any organs? Or do they take the organs and the heart will likely stop beating at that point? Or do they manually stop it first? TIA

 

[airportwoman]

Sadly, I don’t think any of her organs will be usable due the extent of the fire and smoke damage. I guess we will find out soon.

This is a dramatic and sad exit for a gal that seemed to have troubles and struggles the majority of her life. Her loved ones must be in horrible shock and grief. My prayers go out to them. Most of all, a prayer of thanks that no one else was injured, beyond the loss of possessions and peace of mind. That in itself is miraculous given the nature of the events leading up to, and during the crash.

Amateur opinion and speculation

My concern about organ donation in her case would be her history of substance abuse. However, even if her solid organs aren't suitable for transplant, tissue donation (bone, skin, vein, heart valve, corneas, cartilage, etc.) may be a possibility.

My friend's stepson had knee cartilage surgery a couple years ago, and when they found out his couldn't be repaired, they had cadaver cartilage available, and replaced it with that. Of course, they asked if he would have to take rejection drugs, and the answer was no; cartilage does not have much of a blood supply, and by the time his body would reject it, his own tissues would have grown back.

 

[AtlantaBourne]

Rest peacefully, Celestia

 

[neesaki]

So sad. RIP lovely lady.

Actress Anne Heche Dead at 53 After High-Speed Car Crash

Six Days, Seven Nights star dies from injuries she sustained in fiery Los Angeles crash earlier this month

www.rollingstone.com

 

[Only4Justice]

It’s odd. I mean I guess I realize that brain injuries might take some time to be evident, but she was sitting up on the stretcher, and flailing about after they started to cart her away.

Someone with some more education than I about this, could you explain how she goes from that to not expected to survive? What, mechanically is happening in her body to cause that?

I’ll bet it’s the burn injuries. And smoke inhalation

 

[annpats]

I didn't know organ donation is the default law in CA. Unless you choose not to donate, it's going to happen.

New Law in California Makes Organ Donation Easier - Contra Costa Senior Legal Services

California has taken steps to increase the number of organ donors in the State. On January 1, 2019, A.B. 3211 went into effect. The new law makes three changes to California’s Advanced Health Directive (AHCD) law, which clarify patients' rights regarding organ donation. New Law Simplifies Organ...

www.ccsls.org

Sadly it's the same in the UK as of 2021. Organ donation is considered a 'yes' unless you go online and fill out an opt-out from to say no.
I personally think it should be opt-in, but that's just me.

 

[annpats]

I’ll bet it’s the burn injuries. And smoke inhalation

But if she's had an anoxic brain injury (no oxygen) because the fire took all the oxygen and didn't leave any for her, then why was she flailing about on the stretcher?!?

Anoxic brain injuries happen within 4 minutes. She was in the car for 65.

Hypoxic (low oxygen) brain injuries take longer to show, and I think Anne possible had a hypoxic brain injury, and not anoxic...??

Details of the difference between anoxic and hypoxic are below:

Anoxic Brain Injury: Causes, Symptoms, and Treatment | Shepherd Center

Discover the causes, symptoms, and treatment options for anoxic brain injury and anoxic encephalopathy at Shepherd Center.

www.shepherd.org

 

[Only4Justice]

I agree. Not a Dr but married to a firefighter. The toxic fumes will get you first

And doesn’t it burn you from the inside out? Horrible

 

[they'll get you]

It would be the tyres that were screeching due to huge acceleration and a warm surface, no?

Yes, that’s what hubby said.

 

[IceIce9]

Sadly it's the same in the UK as of 2021. Organ donation is considered a 'yes' unless you go online and fill out an opt-out from to say no.
I personally think it should be opt-in, but that's just me.

I think it should be opt-in as well.

I also think it should be mandatory that educational information be provided that explains the different ways that organs, tissue, and body parts can be used. “Transplantation, therapy, research and education” covers a great deal of usages for donated bodies.

I realize that many people believe that donating the body of a loved one means only transplanting lifesaving organs. In some cases, that is exactly what happens. But there are other uses as well, and some might want to indicate the ways that their body or the body of a loved one can be used when donated.

JMO

 

[jbc]

Nurse here, not an MD, but the anoxic brain injury probably didn’t happen when she was in the car. I’d guess she coded while in transport or after arrival at the hospital and it took some time to get her back. Think about performing CPR over burned tissue. Injury to the brain can happen within 3-4 minutes without oxygen. Or depending on her injuries, it may have been very difficult to intubate her or even bag her. With severe burns there is risk of fluid shifting which can cause edema (tissue swelling) and blood flow to her brain could have been affected. Add in the likely smoke inhalation injuries she suffered so her lungs weren’t working as efficiently as they should to exchange oxygen for CO2 in her blood which causes carbon dioxide toxicity and there’s not much that can be done. I think it was CNN that said she slipped into a coma on Monday so I suspect that’s when the brain injury happened. JMO.

ETA-strokes are a huge cause of anoxic brain injuries, so that’s a possibility as well.

Thanks Peppery. That all makes a lot of sense!
I'm sorry to hear all of this about Anne. She had a tortured life.
Goes to show all that looks glittery is not gold.

 

[Kiranerys]

Sadly it's the same in the UK as of 2021. Organ donation is considered a 'yes' unless you go online and fill out an opt-out from to say no.
I personally think it should be opt-in, but that's just me.

I think the opposite personally. Obviously it is something that should be made very clear to the population so you have the chance to opt out,or to specify which organs you are willing to donate but I think its a good thing generally.
A lot of people who carried donor cards and who were registered on the list never had the conversation with their loved ones and made their wishes clear and sometimes relatives didn't accept the choice in the worst moment of their lives and refused to honour the patients wishes and so perfectly viable organs were lost.
I personally don't agree that next of kin should be allowed to over rule a donors wishes,if they carry a donor card and their name is on the list that decision should be honoured. I can see how that would be hard for relatives to bear though.
I have had had discussion with my family,even the younger children,I know their wishes and they know mine and I would urge everyone to have the conversation just in case.

All Moo and all other opinions respected, we are all different