- 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.
Any idea what kind of health complication causes blood to gush from your nose and mouth? Sounds insane to watch especially when you can’t leave the immediate area…
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 scream, “break the ribs!” every time I see movie CPR haha
And then the movie patient pops up and smiles and everything is perfectly restored back to normal instead of, “Oh, we convinced your heart to start beating again, but you’re still unconscious probably because you have brain damage, your kidneys are dying, your blood is acidic, and now we’re gonna put you on a breathing machine. Best wishes!”
My wife and I have both taken CPR classes together. She has very strict wishes about when I should render aid to her. Basically there has to be a 90% chance of an almost instant full recovery before I’m allowed to help her at all if something goes wrong. She knows the risks and so do I. I’m supposed to give her up so I don’t let her down.
Basically there has to be a 90% chance of an almost instant full recovery before I’m allowed to help her at all
Are you able to make the determination, or just haven’t taken a CPR class?
I ask because that’s a lot of pressure put on you, to try to make that kind of emergency diagnosis, especially if you’re not in the medical profession.
I’m still intensely proud of myself for the one time I caved a guy’s sternum in and he woke up to complain about it.
I was an ER tech at the time and he coded in CT (it’s always in CT). So there was a nurse riding the gurney doing compressions while they brought him to the resuscitation bay where I took over compressions. I cracked his sternum on the third compression because, despite having about 75 pounds on me and being on top of the guy, the nurse hadn’t cracked a rib or gotten perfusion. Unfortunately, someone had lost the CPR stool in the resus bay, and I was the only person tall enough to do compressions, so I did it for the full 11 minutes or so of the code in full isolation gear (because Covid). On the second round of amiodarone and defibrillation, he woke up and started fighting the tube that had been placed a few minutes prior. The first thing he said when he came to was that his chest hurt.
He was awake and talking to his family a couple hours later when I took him up to the ICU after all the admission paperwork and whatnot was done.
Why is it always in CT??? That’s an incredible save, if the first round of compressions weren’t really effective. I can’t even imagine doing compressions for 11 minutes at all, let alone in isolation gear. I think I’d join the patient, if I tried that.
And yet everyone looks at me funny when I see the same and yell “sweep the leg!”
If you aren’t breaking ribs you aren’t even trying. Likewise if you aren’t sweeping the legs I have to doubt your comment to Sparkle Motion.
And if you aren’t humming Mad World as you do both, how can you even expect to travel through a worm hole?
There was a recent video I saw where whatever they were using for a body visibly collapsed to dramatize the broken rib thing, and it was horrible to watch. Maybe SkyMed?
I took an infant CPR class at the NICU after my son was born with a slight pneumothorax (air pocket outside his lungs).
They have is these tiny CPR dummies to practice and basically told us to put them on floor and try to press your fingers right through them to the floor. It was so hard to imagine doing it toa real child, and thankfully—6 years in—I haven’t had to.
Much respect to you guys who do it for a living to help the rest of us when we need it most!
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.
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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.
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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.
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 🤢
Is it possibly related to the cabin pressure?
Good question. Gasses certainly expand significantly when ascending to the roughly 5000’ cabin pressure altitude.
Which is readily apparent as the cabin quickly fills with farts. Yes, that’s a thing.
Dissolved gasses in the bloodstream will also be affected by this, though not quite as drastically. Still a thing a though. That’s why you don’t get on a plane (or even hike above 500m) within 24 hours after you’ve been scuba diving.
But if you accidently do, or it’s an emergency and you need to fly, at least for some flights you can ask the flight crew to raise the cabin pressure so you don’t get bent.
So all that said, yes, it certainly could be a possible contributing factor.
Unsure, but it probably didn’t help.
Well that is pretty horrific
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…
I forgot the medical term but when you have a REALLY bad liver the blood starts to take other ways to the heart to circumvent it (kollateral paths).
One path is going through your oesophagus so your venes widen very much. With the widening the risk of a rupture starts to increase very much and as soon as it does, there is nothing much that can save you.
I am not saying he got that but the description fits very much on point.
The word you’re looking for is esophageal varices
Obviously I doubt this but it’s a final phase of ebola.
Nah ebola is more of a oozing bloody mass. Gushing isn’t possible because low blood pressure is another complication. Also, late stage ebola this man wouldn’t be walking anywhere. Let alone well enough to be allowed on a airplane.
Disseminated intravascular coagulation, it’s when you get a bunch of clots, that uses up all your platelets, and you bleed out because you can no longer clot.
This wouldn’t explain what caused the bleed in the first place, nor how rapidly and profusely they were bleeding. Esophageal varices is a better explanation
Yeah, your explanation is probably a better one.
For real, I need a plausible explanation
Check the comments again, seems like we got it 🙂
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Ebola virus?
Oddly enough, alcohol abuse. It’s called esophageal varices.
It’s basically caused by veins in your esophagus rupturing. The same way you can have veins hemorrhage near your anus, causing hemorrhoids. In your esophagus, it’s usually caused by an enlarged liver putting pressure on the surrounding veins. And an enlarged liver is usually caused by end-stage alcoholism.
So the dude had an enlarged liver, (likely sue to a lifetime of alcohol abuse,) popped veins in his esophagus, and started coughing up massive amounts of blood. The dude likely wouldn’t have survived even if he was sitting in an ER when it happened. By the time it happens, it’s usually too late to fix; The victim will drown in their own blood before doctors have a chance to fix it.
But as a random onlooker with no idea what’s happening, it’s absolutely horrifying to see. It looks like something straight out the beginning of a zombie movie. Hell, even if you know exactly what’s happening, it’s still horrifying to see. But at least if you recognize it, you know it’s not contagious.
Source: Dated an EMT for a while, and she had a patient deal with one right after we started dating. I got morbidly curious, and regret the ensuing google searches.
Zingaya
I want to know too
T -virus
Probably scared him too
Still better than flying next to a baby.
Imagine sitting next to this guy when it happens. That must be fuckin traumatizing
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Seems like both suck pretty badly.
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imagine being the one trying to give him CPR
That’s now called “drinking blood”
Blood for the blood god?
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Ruined clothes 😱
Hugs to his family and the poor flight crew who are no doubt traumatized by this and probably having to deal with an investigation, etc.
I’ve seen this movie. It did not end well.
I’ve seen some esophageal varices as a medic and let me tell you those guys are bleeders. Feel bad for people not knowing the situation, it honestly would look like he had something contagious so I can understand the freaking out. People barely survive this with care immediately available in a hospital so he really had no hope once it ruptured.
That was my thought too. A portal hypertensive crisis following exertion leading to rupture of varices. I can’t think of much else that would present like that besides maybe Ebola Zaire or something, but that would have a noticeable prodrome and “coffee grounds” in the emesis.
I have read horror stories that started like this. I am not sure I want to know what happened.
If I was in the plane, I would be like “yep, it’s a coin toss between zombies or the strain.”
I ate a hot dog at the airport in San Juan once. The result is I lost 1/3 of my body weight, but it wasn’t blood.
You are shitting me.
Close.
I’d rather wait for some more reliable sources than Business Insider quoting from Blick. But yeah, scary.
Well, Business Insider did link to flightradar, which shows that the flight in question (they said this past Thursday, which was the 8th) did in fact divert and return to the originating airport at Bangkok on that day. Which isn’t necessarily great evidence, but it’s better than nothing.
This is the best summary I could come up with:
A 63-year-old man died during a Lufthansa flight this week after losing "liters of blood’ in a scene that terrified passengers.
The unidentified man boarded a Lufthansa flight from Bangkok to Munich with his wife on Thursday, according to Swiss-German outlet Blick.
Witnesses Martin and Karin Missfelder told Blick that they sat in the row diagonally behind the male passenger and his wife.
“He then called for a doctor over the loudspeaker and a young, around 30-year-old man from Poland with poor English looked at the German,” Karin Missfelder said.
Data from flightradar24, an online air traffic tracker, showed that the flight departed from the Bangkok International Airport at 12:07 a.m. before diverting back amid the chaos.
Last year, Lufthansa made headlines after a flight from Texas to Germany experienced severe turbulence that sent people and food flying into the air.
The original article contains 457 words, the summary contains 138 words. Saved 70%. I’m a bot and I’m open source!
you guys ever read The Strain?
Time to book an AirBnb in the far away country for 29 days
Seems like over the last couple of days this news is posted everywhere. I’m sure this kind of stuff happens every now and again, so why is it being pushed now? What is the purpose? What are we getting distracted from that needs our attention?
Touch grass dude
Oh great. China to Europe route.
What’s the worst that can happen?
I’m not entirely sure what’s you’re trying to imply. But Bangkok is a city in Thailand.
I believe he’s implying he was asleep during geography.
Lol what? Dude died from complications with alcoholism. Very common way to go once the liver stops working and your esophagus is fried from years of pouring booze down it.
