From Our 2014 Archives
Comedian Joan Rivers Dies at Age 81
By Brenda Goodman, MA
Reviewed by Arefa Cassoobhoy, MD, MPH
Editor's note: This article was updated on Sept. 4, 2014.
Sept. 2, 2014 -- Comedian Joan Rivers died Sept. 4, a week after her heart and breathing stopped during a procedure at a New York endoscopy center, according to media reports. She was 81.
Law enforcement sources told The New York Times and TMZ that Rivers was unconscious and unresponsive when she was rushed to Mount Sinai Hospital last week. She reportedly was in a medically induced coma and on life support.
Her daughter, Melissa Rivers, said in a statement to the media that her mother "passed peacefully ... surrounded by family and close friends."
Bradley Flansbaum, DO, a doctor who specializes in the management of hospitalized patients at Lenox Hill Hospital in New York City, explains why doctors use medically induced comas after sudden cardiac arrest.
Q: What is a medically induced coma?
A: It's part of a protocol we use for patients called advanced cardiac life support, or ACLS.
Doctors can use medications to help slow the body down and let it repair itself, but usually, after a cardiac arrest, critical care physicians will use ice or cooling baths to drop the body's temperature down to induce a similar state.
People in the emergency room, if someone is brought in post-arrest, they'll apply cooling packs or cooling blankets to drop someone's temperature from 98.6 or 99 to 90 or 92 degrees.
Q: Why would doctors use them after cardiac arrest?
A: It's slowing the body down to minimize damage.
To put it in simple terms, if you think of the body as a big machine that requires oxygen and blood, when you slow the body down, it requires less oxygen and less energy than it would normally require. If there's an injury and something happens, like the heart stops, the brain doesn't get enough blood and enough oxygen. So the cells and all the machinery in the brain can become damaged. By lowering the temperature of the brain, it is hoped you can minimize the damage that would occur.
Bradley Flansbaum, DO, MPH, FACP, Lenox Hill Hospital, New York City. New York Times: "Joan Rivers Hospitalized in New York." New York Daily News: "'Fashion Police' taping canceled as Joan Rivers' doctors are to assess her brain damage after bringing her out of coma." Entertainment Tonight. CNN: "Joan Rivers dies at 81."