BEL spill: Lakeman 'critical but stable'
 

Has anyone heard how both Noberto Arroyo & Andrew Lakeman are after the spill in today's 4th race at Belmont?

Lakeman critical with head trauma.. Arroyo stable..

Ouch. It's unfortunate that DaSilva made those comments on the show today.

Hope the kid pulls through.

He just said that Lakeman shouldn't ride a horse again. Bad timing is all.

I didn't see it (thankfully), but hopefully he makes it..

J. DaSilva reporting Lakeman on life support.. Place him in your prayers.

Really sorry to hear that. Looked bad when it happened.

Thoughts and prayers to Andrew and his family and friends.

de silva he an ******* ,,, sonny speaks..get better andrew.

On Lifesupport Is Not A Sign Of Impending Death
 

Steve

I would be very careful drawing conclusions about prognosis based on the phrase "on life support"......

All this means is that Lakeman is being treated with hyperventilation. This is basic to treatment of all blunt head trauma cases as a first modality to lower the pressure in his head.

By breathing fast for him using a ventilator the blood vessels actually constrict thus taking up less room in his head which lowers the pressure TEMPORARILY in his head.

This is the first thing done in head trauma cases. The fact that he didn't go immediately to surgery is actually encouraging. If he was actively bleeding in his head a pressure monitor would be placed in the operating room to drain blood which apparently wasn't necessary by reports.

I will certainly say a prayer for him tonight myself as he is certainly critically ill but I wouldn't assume death is near unless more information is brought to light.

Please don't take the fact that he is intubated on a ventilator as any more than appropriate trauma treatment. This is one of the most commonly misunderstood issues in all of critical care medicine.

Dr D

He is in my prayers... :(

Am hoping that docicu3 is correct.

Oh how awful. I will
keep them both in
my prayers. Sending good
vibes and get well wishes.
You can do it guys!

DD,

You certainly know more on how to interpret the info than us, so, 'from your mouth to G-d's ears' as we say...

This is terribly tragic, my thoughts and prayers with Lakeman and his family for a full recovery.

I certainly do not want to imply that I KNOW this guys case but hopefully the usual standards of care will apply.

Please understand that I have no first hand knowledge of his moment to moment condition but can hopefully ease a few hearts about the info available.

Do you know for sure what hospital Lakeman is admitted to as the local hospital to the track is not a Level 1 trauma center which is where a case like this is normally taken once triaged appropriately.

just saw the race replay...horrific.


Prayers to Mr. Lakeman and his family.

Our Montana Dream was continually checked prior to clipping heels. She didn't appear to have any room and clipped heels on the rail. I sincelrely hope all are well. Here is the replay.
http://www.racereplays.com/nybreds/i...cename=friday1

boy that was bad I hope it all turns out ok

Belmont jockys go to North Shore University Hospital and they do have a level 1 trauma center. I am not positive that he went there, but I'm pretty sure.

If I looked up the right place North Shore Long Island Jewish is a full service Level 1 trauma center so I stand corrected above.

So why were the jocks complaining last year about medical services or was that during the Aqueduct season?

That was during Aqueduct, North Shore is where they wanted to be taken from Aqueduct as well.

At AQU the primary ER center is Jamaica Hosp., not North Shore. At BEL is is North Shore.

I add my prayers for Andrew Lakeman.

I haven't seen any updates on this yet in the press today. Anybody?

It is always disturbing to me, when I win money on a race where a horse or jockey is injured, or worse. Emphasizes the frivolity and luxury of my entertainment within the big picture. Another typical 4th race at Belmont, on just another weekday afternoon ... how many fans will remember this incident next week? Remember Andrew Lakemans name in a month?

I was wondering how the average fan, who owes a great deal to the men and women that choose to put their lives on the line in the saddle on a daily basis, could get involved or contribute. We have contributed hundreds of thousands to the horses that we owe so much to, before and after Barbaro. I think the interest and care on the part of the fans is there, obviously.

Anyway, yesterday I e-mailed Pat Day, Racetrack Chaplaincy of America, to see if there is any way an average joe could contribute positively when such a tragic situation occurs. I'd much rather Lakeman and his family have the money I won yesterday, if they could use it. If I hear anything, I'll let you guys know.

The latest:

http://www.drf.com/news/article/85256.html

You can also call the jocks room at the track and find out if they have a sign up sheet or where you can send money , its a common thing for there to be a list for riders donating jock mounts to assist hurt riders.

I live 1.5 miles from North Shore.It's an excellent hospital with state of the art care.Best place place he could've gone to.If it were at Aqueduct good chance they would've taken him to Jamaica hospital otherwise known as Mary Immaculate.Another excellent hospital for Trauma.

Update...

http://drf.com/news/article/85269.html

If there is anything good about such a traumatic injury it is the part of the story that says "he did not have head trauma".....this means he is likely to live folks.

The fact that they used a "rapid infusion transfusion pump" speakes again to standard technology.

Soon they will likely release info on whether he has sensation in his legs as they already are telling you "he is much improved".....

Although concerns about his ability to move his extremities remain "stable but critical" is the best you could have hoped for here.

This is all actually great news.....the next hurdles are 1) extubation (remove the vent) 2) stabilizing his cord injury in hopes of avoiding a) an operation for a hematoma on his cord b) infection here or elsewhere

Keep saying those prayers but a few have already been answered.

Dr D

Thanks, Honu. Will do.

Riot, that is a very honorbale act on your part and I am sure his family will be very appreciative.

Best wishes for speedy recovery.

Jamaica Hospital and Mary Immac. are two seperate shops. For what it's worth, I would go to Jamaica with Trauma over Mary Immac.

Anyone have news on this today??

No News, But A Question
 

Docicu3, when you have a moment, can you venture a guess as to whether the following excerpt from Saturday's DRF piece on Andrew Lakeman's treatment contained a typo?

At http://www.drf.com/news/article/85269.html, the article said in part:

Two quarts in two minutes? Could they have meant two pints in two minutes?

Thanks.

i hope he recovers, sounds like he's in for a tremendously tough time tho...but jocks are in pretty good shape, and that will help him in his fight.
riot, if you find anything, i know you said you'll let us know...hopefully you or someone will find an answer of who to contact.

Packed cells actually come in units which are intended to raise a hemoglobin by 1 gram/DL or hematocrit by 3%. The volume of a bag varies by the amount of plasma in it, or volume of material other than red cells. The bag holds 390 mls.

The usual way this is done is when a patient in hypovolemic shock from
hemorhage comes into a trauma unit time is of the essence so they infuse "O"
negative blood which is a match for any blood type. These units are placed in a "rapid infuser" which infuse a "unit" of packed cells in less than a minute.

To answer the question though the medical people probably used the lingo we are used to in critical care and said they give Lakeman 2 units of blood in 2 minutes. It makes it sound unique if they don't tell you about the equipment which has become a common device in ED's and Trauma bays.
For the anal among us a unit = 0.1 gallon = 0.4 quarts = 0.8 pints.

Of note is the current controversy with using "polyheme" in situations like Lakeman's where a trauma patient needs rapid transfusion and there is only so much "O" negative blood in the world as the other types A, B, AB and +Rh units make up the majority of transfusions.

The front page of the Washington Post yesterday layed out the ethical argument in reference to "Is it ethical to do studies of resuscitation without true informed consent?" The gravely ill hardly are candidates for long consent procedures however the individual's rights must be preserved if at all possible. A number of trials are underway in university hospitals across the country trying to improve outcome in situations like Lakeman's using artificial volume expanders like "polyheme" a dextran type substance used to simulate blood to reverse shock before damage is done to organs of the body.

Other studies are about the resuscitations themselves with such projects as
1) hypothermia in cardiac arrest (if I cool a body to 32C within a short time of a heart stopping more people live with less impairment neurologically than if I don't) 2) shock vs CPR for first therapies in arrest situations etc. I am simplifying this greatly but since people seem interested I thought I would oblige.....I'm sure I put you all to sleep....lol.

DD

Dr D: Anytime you can cheat Death is a good time,right?:D Thanks for info..was interesting and may be helpful in future.

Dr.D - Thanks for the explanation. Hopefully the DRF article meant to say two "units."

Can't find any updates on Lakeman's condition. If anyone would like to pass along their good wishes, the address is:

Mr. Andrew Lakeman
North Shore University Hospital
ICU
300 Community Drive
Manhasset, New York 11030

Anybody got an update this week on this???