Joan Rivers

Comedian Joan Rivers is reportedly in a medically-induced coma to relieve swelling in her brain after she stopped breathing during a routine endoscopy procedure at an outpatient clinic in NY yesterday.

Rivers, 81, was reportedly undergoing a non-surgical endoscopic procedure at Yorkville Endoscopy clinic when she experienced respiratory and cardiac arrest as a result of a lack of oxygen to her brain.

Rivers was transported to Mount Sinai hospital, where she remains in critical but stable condition in an intensive care unit.

During a routine endoscopy, a doctor inserts a long, flexible tube with a camera and light at the end of it into a patient’s throat to look for abnormalities on internal structures in the throat, esophagus or stomach.

99% of the time this procedure is safe and uneventful. But with every procedure there are always risks or complications involved. That’s why patients are required to sign a standard form acknowledging that they understand the risks that are involved.

Usually there are 2-3 people in the room with a patient who is undergoing a routine endoscopy procedure: a doctor, a nurse and, or a technician. If all 3 health professionals are distracted by watching the video monitor, no one is monitoring the patient to see if he or she is breathing.

At the end of the procedure, the patient does not wake up. This is when doctors and nurses are alerted that something has gone horribly wrong.

If a patient is undergoing a surgical procedure in a hospital, there is always an anesthesiologist monitoring the patient’s breathing and vital signs. The patient is also hooked up to machines that will beep loudly to alert the doctor that the level of carbon dioxide (C02) is rising to dangerous levels in the blood. C02 levels rise when a patient’s breathing slows to below 12 breaths per minute — or stops breathing altogether.

Once the breathing stops, the normal exchange of oxygen into the lungs and carbon dioxide out of the lungs does not occur. Hypoxia occurs when there is a lack of oxygen to the brain which leads to a dangerous build up of C02 in the brain that causes the brain to swell. Death occurs if the swelling is not decreased.

Doctors will give the patient medications to reduce the brain swelling so the brain can get oxygen.

Brain scans will tell doctors if there is any brain damage from the lack of oxygen and if Rivers’ brain is functioning at a level to sustain life.

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