Friday, July 24, 2015

You’re not dead until you’re warm and dead

A 22-month-old toddler was revived after falling into a frigid creek near his home and undergoing 101 minutes of CPR -- a recovery that one doctor said may have been made possible by a type of "suspended animation."

Gardell Martin was pulled from a nearly frozen creek March 11 after going missing for approximately 20 minutes, said his mother, Rose Martin. The toddler had been playing outdoors with his older brother near their home in Mifflinburg, Pennsylvania, when he fell into the fast-moving water.
By the time a neighbor found Gardell, the boy was face-up in the water and was not responsive, his mother said.

Emergency crews started CPR, which continued as the boy was flown to Geisinger’s Janet Weis Children’s Hospital, where he was rushed to the critical care department, according to ABC News affiliate WNEP-TV in Scranton, Pennsylvania.
"A couple things were in his favor," Rose Martin told ABC News. "The cold water helped preserve his organs and his brain."

A hospital official confirmed that Gardell's body temperature was a frigid 77 degrees when he arrived for care. As CPR continued, doctors worked to warm the boy up and see if his heart could get started. After 101 minutes of continuous CPR, doctors found a tentative pulse.
“In my 23 years, I have not seen an hour-and-41-minutes comeback to this degree of neurological recovery,” said Dr. Frank Maffei, a pediatric critical care doctor at Geisinger Medical Center in Danville, Pennsylvania. "That doesn’t happen by accident. It happens because people are trained."
Dr. Alexandre Rotta, chief of pediatric critical care medicine at UH Rainbow Babies and Children's Hospital in Cleveland, said the case clearly demonstrates how, in rare cases, hypothermia can lead to a kind of "suspended animation" that can protect the body when the heart stops.
"Hypothermia has been known for years to slow down metabolism," said Rotta, who said at around 77 degrees a body needs only 30 percent of its normal oxygen intake, which can help preserve the organs...
"At 28 degrees Celsius [82 degrees Fahrenheit], [you] can safely arrest someone for 20 minutes," Rotta said. "There was a saying ... that you’re not dead until you’re warm and dead."...
However, Rotta said, these cases are extremely rare and he, himself, has seen only one case of a child coming back after being found in cold water in cardiac arrest.
"These cases are out there, but it requires tremendous [luck] your way," he said.
Gardell's mother told ABC News the family is just happy to have the toddler back at home and "pretty much back to normal" after his ordeal. She said his relatives feel his survival was "an act of God."
"I feel like we’re trying to get back to normal life and everyone is trying to get back to normal," said Martin. "He’s smothered with love. We can’t give him enough attention right now."

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