Girl, 4, unconscious after 18-minute cardiac arrest

Wallis Wang and Eunice Lam

A four-year-old girl is in critical condition after an 18-minute cardiac arrest following stitches at Yan Chai Hospital.

The girl, diagnosed with brain dysfunction due to a lack of blood flow, is suffering from a brain edema and remained unconscious at the pediatric intensive care unit at Princess Margaret Hospital.

Yan Chai Hospital chief executive Ian Cheung Tsz-fung said the girl was sent to the hospital's emergency room by an ambulance on Saturday accompanied by her father after she fell at home and hurt her head.

After preliminary examination and assessment, medics found a two-centimeter wound on the back of the girl's head. She also nursed a slight fever but there appeared to be no injuries to her chest and skull.

The hospital's Chief of Service of Accident and Emergency Department Lin Wai-hung said a nurse and a patient care assistant were responsible for giving the girl three stitches.

Lin said the girl was lying on her stomach for the stitches, and she cried and struggled during the first stitch. The patient care assistant then used hands to immobilize her head. "It's common that children would struggle when receiving stitches. To ensure patients' safety, we have fixed procedures to immobilize them so they won't move violently and hurt themselves. [Our medical team] was following the existing procedures," he said.

The stitching process lasted for three minutes. However, medics found the girl lost consciousness and pulse after it, Lin said. The girl's heartbeat resumed after 18 minutes of rescue and an X-ray examination showed there was no abnormality in her lungs and brain, he said.

Cheung said the girl was later transferred to Princess Margaret Hospital in Kwai Chung and is receiving treatment at the pediatric intensive care unit.

She was diagnosed with hypoxic-ischemic encephalopathy - a brain dysfunction due to a decrease in blood flow - and remained in critical condition as of yesterday evening. The girl requires a ventilator and is taking cardiac agents and medications to control her epilepsy and brain edema, as well as antibiotics and nutrition injections.

The hospital also said the tools used for the stitches were sterilized. The girl has no history of heart disease or chronic disease, her electrocardiogram and cardiac ultrasound results upon admission were also normal.

Deputizing Cluster chiefexecutive of the Hospital Authority's Kowloon West Cluster Desmond Nguyen Gia-hung said the incident was rare and a professional team will investigate the cause, saying: "We will learn more about the child's situation to find out if she has any underlying diseases that caused or relate to the cardiac arrest this time."