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Anoxic Brain Injury Causes

by John Gomez | Last Updated: February 26, 2020

It tugs at your heart when you see someone rescue a drowning child, even when it’s a total stranger. Your anxiety eases when rescuers resuscitate her and she resumes breathing. You feel relief as the medical team transports the child for emergency treatment. Unless you’re a close family member, you’ll never know the end of the story. You may never find out if the child returns to her normal life, or spends a lifetime with mental and physical impairments caused by an anoxic brain injury.

The Brain Injury Association of America authored this simple yet accurate description: “A brain injury changes the way you move, act, think, and feel—it has the potential to change who you are at your core.” Their informational response focused on traumatic brain injuries, but when anoxia causes the damage, an injured person endures a similar outcome. Just like a TBI, anoxic brain damage profoundly affects the injured person’s life.

What Is an Anoxic Brain Injury?

Ben Coughlan
An anoxic brain injury occurs when the brain’s oxygen supply is cut off or limited. The brain can’t produce oxygen, so it relies on a constant supply delivered via blood flow. When a person can’t breathe, it disrupts that supply, causing anoxic brain damage. Some anoxic injuries begin with hypoxia, which occurs when a condition restricts but doesn’t eliminate oxygen from reaching the body and brain.

As the Brain Injury Association of America explains, anoxic brain damage is considered an acquired brain injury because it’s not “hereditary, congenital, degenerative, or induced by birth trauma.” In ways similar to a stroke or other health conditions, anoxic damage occurs because an “internal force” alters the brain’s functioning. Traumatic brain injuries occur due to an “external force.”

During near-drownings and other extreme events that compromise a person’s oxygen flow, the brain receives no oxygen at all. When a person remains oxygen-deprived for long periods, they are less likely to recover completely. As oxygen-deprivation continues, it damages the brain, other organs, and delicate body tissues. Continued oxygen loss often causes permanent damage or death.

As with severe TBIs, people with severe anoxic brain injuries sometimes die immediately. If they survive, they often deal with a lifetime of severe disabilities. Some people with severe anoxic brain injuries enter a coma or a vegetative state. If a coma state doesn’t resolve, the person eventually dies.

Anoxic Brain Injury Damage

As with any type of brain injury, longterm symptoms may vary. It may depend on the degree of exposure to adverse conditions, and the person’s physical condition. In some cases, the loss of oxygen affects not only the brain but also the heart, kidneys, and tissues throughout the body.

When an emergency team immediately reintroduces oxygen to an injured victim, they sometimes recover. Others struggle with lifelong disabilities:

  • Cognitive changes
  • Severe headaches
  • Speech and vision difficulties
  • Motor impairments
  • Personality changes
  • Long-term memory issues
  • Depression and anxiety
  • Fatigue
  • Sleep difficulties
  • Psychological difficulties

What Causes Anoxic Brain Injuries?

Near-drowning is just one of the extreme incidents that cause anoxic brain damage. Oxygen deprivation events occur at home, on the job, during recreational events, and other activities. They occur during any activity with the potential to cut off the brain from its oxygen supply.


Drowning is “…the process of experiencing respiratory impairment from submersion/immersion in liquid.” The World Congress on Drowning drafted this formal definition in 2002. As drowning is a worldwide concern, they wanted to establish internationally consistent terminology. The organization worded the description to acknowledge that drowning includes both fatal and non-fatal injuries, and that both are serious problems.

The California Department of Developmental Services worked with local and regional organizations in establishing the “Drowning is Silent” campaign. They seek to dispel drowning ideations that prevent parents and bystanders from recognizing that a swimmer is in distress. Some people believe the myth that drowning victims scream, kick, and splash to draw attention. This belief prevents them from realizing that a swimmer is drowning. As the victim’s body “gives in” to the water, they are usually silent. Even when they’re standing nearby, family members and bystanders who don’t understand this miss the opportunity to rescue a drowning victim.

Although most drownings occur in residential settings, they also take place in community pools, hotel pools, lakes, rivers, and other recreational areas. Children also “drown” due to submersion injuries in kiddie pools, bathtubs, buckets of water and other places where water is easily accessible.

The DDS, the Centers for Disease Control and Prevention, and the Drowning Prevention Foundation provide these facts about drowning.

  • Drowning is the leading cause of death among children ages 1 to 14.
  • For each child documented as having fatal injuries, five children receive emergency care for nonfatal submersion injuries.
  • Half of the children treated for drowning injuries required further hospitalization.
  • A child can drown in 1 minute in as little as 1 inch of water.
  • Drowning kills more California toddlers than any other type of accident.
  • If a child survives a near-drowning, they often sustain permanent brain damage.

Trench Collapses on Construction Sites

Anoxic brain injuries are often the least horrific outcome given an accident’s circumstances. That’s often the case with construction site trench collapses. They usually occur when a construction worker is performing a task in a deep trench or within an underground worksite. If the supervising contractor hasn’t shored up the trench, the soil walls sometimes collapse and bury the workers.

When a trench collapse occurs, it’s often a search effort instead of a rescue. When dirt completely covers a worker, it cuts off his air supply and prevents his brain from receiving oxygen. If no one knows exactly where the person was working when the collapse occurred, a rescue team has only minutes to locate the buried worker and then remove the soil. Because timing is so critical, workers often die in trench collapses. When they survive, they often deal with anoxic brain damage caused by complete oxygen deprivation.

Contractors understand trench collapse dynamics but they don’t always secure dirt walls. Because of cost-saving considerations, they often bypass the shoring that’s necessary to prevent a wall of dirt from collapsing. The Occupational Health and Safety Administration (OSHA) and its regional affiliate, Cal/OSHA, often cite contractors for this clear standards violation.

That was the case when Cal/OSHA issued violations to a contractor for failure to implement an adequate protective system. As a result of the contractor’s ineffectual safety precautions, a worker died in a trench collapse. The citation included fines totaling $24,670. Unfortunately, contractors sometimes see OSHA fines as a cost of doing business. Trench collapses continue to injure workers as paying fines often costs less than the labor to shore up a trench’s dirt walls.


Suffocation is the primary cause of death for children under 1-year-old. When suffocation cuts off the oxygen supply but doesn’t cause fatal injuries, the child sometimes sustains anoxic brain damage.

Suffocation incidents often occur while a child is sleeping. A research group who studied five years of data from the Sudden Unexpected Infant Death Case Registry found that many incidents occurred due to soft bedding, padding, and unsafe sleeping arrangements.

In some cases, children died or sustained brain injuries because of defective bedding, beds, and other defective products. In recent years, the Consumer Product Safety Commission has initiated recalls for baby products due to potential suffocation hazards

  • Portable baby sleepers/seats/nappers: Children roll over and suffocate while strapped into sleepers. The Fisher-Price Rock N’ Play Sleeper is one recent example.
  • Baby slings and wraps: CPSC recommended that manufacturers include more instructions on proper carrier use after 14 babies died. Some carrying positions cause breathing difficulties for young babies.
  • Cribs: The CPSC and manufacturers continuously push to rid homes of older cribs with drop sides or slats that cause entrapment or suffocation.
  • Bean Bag chairs: Several manufacturers recalled their bean bag chairs due to suffocation and entrapment hazards.


When strangulation cuts off a person’s air supply, it sometimes causes anoxic brain damage. Strangulation is often an intentional act of violence. It also occurs due to defective products.

  • Window blinds and shades: The long cords on certain window treatments present a serious strangulation hazard. Manufacturers usually include a hang-tag with multiple strangulation warnings to minimize the chance of child injuries.
  • Clothing: A Canadian manufacturer recently recalled its hooded sweatshirt as the drawstrings could get caught in playground equipment, school bus doors, and other objects.

Carbon Monoxide Poisoning

Exposure to carbon monoxide often kills or seriously injures a person in minutes. When someone inhales the chemical, it causes hypoxia, diminished oxygen intake and/or anoxia, complete oxygen deprivation. Nationally, the CDC estimates that 430 or more people die of carbon monoxide-related deaths each year. An additional 50,000 people seek emergency room treatment.

CO exposures cause brain damage. The degree of injury depends on a victim’s level of CO exposure and the amount of time spent in a contaminated environment. A person with CO poisoning often feels flu-like symptoms such as dizziness, achiness, and fatigue. The symptoms increase with higher, longer exposures.

  • Confusion
  • Loss of consciousness
  • Lost muscle control
  • Limb tingling and numbness

Carbon monoxide is a byproduct of burning coal, charcoal, oil, kerosene, propane, natural gas, other fossil fuels, and wood. This occurs most frequently with furnaces, heaters, generators, and vehicles in enclosed spaces. CO problems occur due to poorly maintained furnaces and boilers or when a person uses wood-burning or fossil fuel-powered heat sources indoors.

CO exposure sometimes occurs when a product is defective. Recent CPSC recalls involve defective boilers manufactured by Bosch Thermotechnology and Viessmann. The manufacturers recalled both products due to carbon monoxide hazards.

Drug Overdose

The opioid epidemic is considered the deadliest drug crisis in American history. While the media publicizes opioid addiction and deaths, the Brain Injury Association of America believes that the public isn’t receiving enough information about the opioid connection to anoxic and hypoxic brain injuries. These injuries are one of the rarely-publicized non-fatal consequences.

Physicians prescribe opioids for pain and inflammation associated with injuries, surgical procedures, palliative care, and arthritis. Patients often continue using legal and illegal opiates because of the enhanced sense of euphoria they generate. As a result, opioid overdose is the leading cause of death of American adults under age 50. Survivors don’t always escape adverse outcomes. They sometimes sustain non-fatal injuries that require brain injury rehabilitation.

In the report “Non-lethal Opioid Overdose and Acquired Brain Injury,” the BIAA explains how opioids affect the brain. They aren’t classified as system depressants, but they depress a user’s respiratory and gastrointestinal systems. In response to an opioid overdose, the respiratory system sometimes goes into distress or arrest. This interferes with the body’s oxygen supply and often causes hypoxic and/or anoxic brain injuries.

Hypoxic damage occurs when drug use prevents an adequate oxygen supply from reaching the brain and other parts of the body. An anoxic injury occurs when a drug overdose completely deprives the brain of oxygen. Cell death begins within 5 to 6 minutes of opioid-induced oxygen deprivation.

While substance misuse is often considered the result of treatment for brain injuries, some researchers believe that drug and alcohol misuse often cause brain injuries. Brain injury experts have also found that chronic methadone treatment sometimes causes cognitive damage.

How a Brain Injury Attorney Can Help You

If you or a family member sustained an anoxic or hypoxic brain injury, a legal representative can protect your rights. A brain injury claim requires a complex assessment and presentation of liability and damage issues, something you can gain by working with an experienced brain injury attorney.

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