Heart Education Awareness Resource and Training through eLearning (HEARTe)

Sean goes to hospital

Sean’s condition is critical and a decision is taken to dispatch an air ambulance to transport him to the nearest available intensive care bed. A helicopter arrives after another 20 minutes and delivers Sean to the nearest major hospital in just under an hour. Sean spends 48 hours in the intensive care unit. Although he is haemodynamically stable, Sean has acquired significant brain injuries.

The majority of those who survive an out of hospital cardiac arrest do not have significant neurological impairments. However, a small minority are left with severe brain injuries. This has major implications not only for the patient, but also for their family and loved ones. For information on brain injury following an OHCA, please see the following presentation by Lynne Atkinson, Edinburgh Headway:

Hypoxic/Anoxic Brain Injury

  • Hypoxic Brain Injury – reduced oxygen supply to the brain
  • Anoxic Brain Injury – interruption/no oxygen being supplied to the brain

The brain uses 20% of the oxygen you breathe. Nerve cells in the brain demand a high level of energy, thus after 4 minutes of reduced oxygen, brain cells will start to die.

The effects of hypoxic or anoxic brain injury can range from mild, short term symptoms such as reduced concentration and dizziness to longer term issues including speech and memory, dependant on the level of hypoxia experienced.

4 Main consequences of Brain Injuries
  1. Physical
  2. Cognitive
  3. Executive
  4. Psychosocial
Physical issues
  • Muscle weakness
  • Speaking difficulties
  • Tiredness/neural fatigue
  • Coordination/balance problems
  • Changes in sensation
  • Difficulty moving body parts in isolation
  • Neuropathic pain
Cognitive issues
  • Disorientation to time, place & person
  • Memory difficulties
  • Attention problems
  • Information processing problems
  • Spatial and constructional problems
  • Language problems
Executive Issues
  • Goal setting
  • Planning
  • Organisation
  • Self initiation
  • Self evaluation and monitoring
  • Flexible problem solving
  • Cannot predict consequences
  • Cannot monitor, predict or conceptualise time or money
Psychosocial
  • Personality changes
  • Reduced tolerance to frustration
  • Irritability
  • Emotional lability
  • Inhibition/impulsivity problems
  • Mood and emotional changes
  • Relationship difficulties
  • Reduced awareness/insight
  • Loss of motivation
  • Pragmatic disorder/dysfunction

The long term consequences are dependant on the severity of the anoxia and how much irreversible damage has occurred.

If there has only been mild anoxia, the person may make a recovery back to normal or near normal level of functioning.

For more information, please contact:

Edinburgh Headway Group
Headway House
Astley Ainslie Hospital
Canaan Lane
EDINBURGH
EH9 2HL

Tel: 0131 537 9116
Email: Edinburgh Headway
Website: Edinburgh Headway Group

Following his resuscitation, Sean was hospitalised for several months and required intensive rehabilitation. Further useful information on brain injury and rehabilitation can be found at:

Page last reviewed: 15 Oct 2020