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British woman revived after six-hour cardiac arrest
- afthonos 7y agoI read somewhere "you are not dead until you're warm and dead". Data point in favor.
- divbyzer0 7y agoCorrect. Hypothermia and drowning (particulartly in cold water) the patient is not pronounced dead until the body has been warmed, this can be 12+ hours after the event. Children do better. The mammalian diving reflex prepares the body for long periods of immersion. Not to be relied upon. https://en.wikipedia.org/wiki/Diving_reflex https://en.wikipedia.org/wiki/Diving_reflex
- nso 7y agoThere was just a case in Norway with what looks like a mom drowning herself and her 3 children. The mom and the eldest expired, while the two youngest were brought up and are in critical condition but alive.
- kls 7y agoIt is a true reflex I practice breath holds due to the fact that I spearfish, when I started I could hold my breath for about a minute out of water and less than 2 in water. Funny part is usually you second or third hold is the longest as your body due to the reflex tends to adapt to the higher CO2 levels in it, on the second and third breath hold. I can now hold my breath in water for over 5 minutes due to CO2 desensitization. The average person with training can hold for 8 minutes without loosing consciousness if they are calm and and resist the urge to breath. I have never tried to push past 5 as it leaves a decent window and 5 minutes is a really long time underwater. I can spend 2 minutes at 100 ft with a 5 minute breath hold. I am 45 and am in average to just slightly above average shape for a 45 year old.
- isolli 7y agoHow cold is the water? It has to be cold, right?
- kls 7y agoNo the reflex does not depend on temperature. The immersion in water is what initiates the reflex. Though it is true that cooler water prolongs the reflex. I spearfish in the Caribbean so average water temps are 70s-80s. It is the struggling and adrenaline that causes rapid loss of consciousnesses in water, as it rapidly depletes oxygen and works against the reflex. If one calms themselves and uses deliberate movement 5 minutes is achievable in 2-3 months of training in tropical waters, by an individual in average health. When we spearfish we don't race to the bottom or rocket to the top, we use a lazy peddling motion to slowly decent and ascend. It helps in preservation of oxygen, once on bottom we usually hover in one spot, and try to remain still while almost meditating. We only move while actively hunting a particular fish once spotted. While the reflex is active your mind can work with the reflex to help it shut systems down and focus blood to the brain which is what it is doing. Each movement reactivates a system, eating before a dive activates a system, not using the restroom before a dive can leave a system active (though the reflex generally tries to shut that down by increasing the urge as soon as you enter the water, hence the have to pee when you get in the pool reflex).
- huherto 7y agoSpear fishing sounds really nice. Too bad I am VERY afraid of sharks. Yes I saw Jaws when I was a kid.
- kls 7y agoWhen you have been in the water long enough sharks are a natural encounter. After a while they just become part of the landscape to you. They are attracted to the struggling fish and will try to bully you for your fish but rarely are you their main attraction. When you realize that they are a lot like dogs is when your attitude starts to change with about them being around. You realize if you stand your ground give them a nudge with your spear, they generally loose interest really quickly. They avoid fighting for or with their meal. They always say it is the shark that you don't see that will get you and it is true. As long as your keep them in your sight, and confront them they will loose interest. I am no more afraid of a shark nowadays than I am a dog. You give them respect but you stand firm. I have only ever been in one really hairy situation and that was with a persistent 14 ft Tiger shark. Long story short after several nudges with my spear, and it just circling back around, I used what we call a blowfish defense on it, where you ball up and as they are coming in you stretch out your body, arms and legs quickly. That was enough to startle it and cause it to loose interest. That was the first and last time I have ever had to blowfish, All of the rest where easily persuaded that I was going to fight for my meal.
- fireattack 7y agoFound this by googling: https://www.ncbi.nlm.nih.gov/pubmed/24882104 https://www.ncbi.nlm.nih.gov/pubmed/24882104
- johnnycab 7y agoYour comment reminded me of this: https://en.wikipedia.org/wiki/Anna_Bågenholm https://en.wikipedia.org/wiki/Anna_Bågenholm The electrocardiogram connected to her showed no signs of life,[2] but Gilbert knew patients should be "warmed up before you declare them dead".[25]
- jobigoud 7y ago> In a race against time, doctors treating Mrs Schoeman turned to a specialised machine capable of removing blood, infusing it with oxygen and reintroducing it to the patient. > Once her body temperature had reached 30C, they used a defibrillator to jump-start her heart some six hours after emergency services were contacted. > Mrs Schoeman was released from hospital 12 days later, with only some lingering issues with the mobility and sensitivity of her hands due to the hypothermia. > How long her heart stopped for is not clear - she may still have had some circulation, although not detectable.
- samstave 7y agoJust out of curiosity - would one (say like a soldier) be able to effectively 'pre-emptively' wear a device in a backpack which has a permanent-ish lead to the circulatory system which does multiple things: Provides a constant flow of oxygenated blood which allows for higher endurance, longer "holding of breath", and in the case of severe injury, oxygenated blood circulation to prevent death (unless there is catastrophic blood loss which moots the machine's ability).... Recall all the famous designs of Cyborgs [and The Borg] with the tubes running into their face/head/nose - the tubes could be pumping externally oxygenated blood to the vitals which would suffer most in catastrophic physical unplanned destruction events.
- aedocw 7y agoWhere would the oxygenated blood come from? How much would the soldier have to carry? How do you protect this mechanism so that it's not also damaged in whatever unplanned destruction event broke the soldier?
- stuartbman 7y agoECMO is an amazing technology that's often used in futile situations. I don't know who the ideal candidate is for it, but a young, fit, hypothermic cardiac arrest victim is pretty high up on the list
- Jare 7y agoI don't know about ideal, but it saved my 6 day old son so yeah, "amazing" is totally warranted. Years later I sometimes take a look at some of the pictures we took (cameras would be forbidden in ICU soon after) and stare in awe.
- sillysaurusx 7y agoThat's incredible! Are the pictures online anywhere?
- voldacar 7y agoThis sounds like a great story - would you be willing to share it?
- Jare 7y agoAs a long time game developer, I have the desire to tell it in my medium. The story is still ongoing 5 years later, but unfortunately so is the struggle, so it is very rare to find the combination of spare time, energy, and confidence to go past drafts and ideas.
- 7y ago
- jacquesm 7y agoRelated: https://www.iflscience.com/health-and-medicine/child-survived-almost-2-hours-cpr-after-falling-icy-stream-how/ https://www.iflscience.com/health-and-medicine/child-survive... There are a few such known examples, also some that looked good for a while but ended with a tragedy as much as a day later. I can see some parallels with the drowning case due to the hypothermia, the onset of which must have been relatively fast.
- TheSpiceIsLife 7y agoAlso this cat: https://www.abc.net.au/news/2019-02-08/cat-thawed-out-after-being-stuck-in-snow/10792816 https://www.abc.net.au/news/2019-02-08/cat-thawed-out-after-...
- bhickey 7y agoOutside has a good narrative of hypothermia. https://www.outsideonline.com/2152131/freezing-death https://www.outsideonline.com/2152131/freezing-death
- Tepix 7y agoSo, I still don't know if you are irreversibly dead if your brain stops all activity. I.e. is the state of your brain preserved just by the connections of the neurons? Or is the "RAM" also critical?
- adrianN 7y agoElectrocuting the brain like in electroshock therapy most likely wipes any electrical activity. That seems to indicate that the brain is able to recover after such an event.
- mkesper 7y agoWhen your brain doesn't get oxygen it will die. See https://en.wikipedia.org/wiki/Cerebral_hypoxia https://en.wikipedia.org/wiki/Cerebral_hypoxia
- unnouinceput 7y agoIt's more then that in this case. She had not vital signs at all, heart not beating and providing oxygen included.
- pc86 7y agoThe brain was provided oxygen, just not by her heart.
- meowface 7y agoAlso, perhaps during such a cold state more cells are able to stay alive despite having less oxygen to work with? Maybe due to a reduction in how much energy they use or need per unit time? Just speculating.
- heavyset_go 7y agoCell death is a metabolic process and it can be arrested if overall metabolism is arrested, as well.
- BigChiefSmokem 7y agoHow did her brain survive with seemingly no oxygen being replenished thru circulation?
- me_me_me 7y ago>Audrey Schoeman developed severe hypothermia when she was caught in a snowstorm while hiking in the Spanish Pyrenees with her husband in November.
- throwthisaway01 7y agoIf you read the article, she was hiking in a snowy area and they believe hypothermia helped preserve her while her heart was stopped
- zaarn 7y agoBy being cold.
- orobinson 7y agoIt’s amazing how this phenomenon has been adapted into medical technology. When my son was born he wasn’t breathing properly and his blood oxygen levels dropped to critical levels. He was rushed to hospital and the first thing they did was cool him to 34c to reduce the risk of brain damage. He made a full recovery. I dread to think what would have happened without the cooling.
- zozbot234 7y agoWhy not cool the patient before rushing them to hospital, if the technique is so widely applicable? It could easily be made a standard feature of emergency medical services.
- TomMarius 7y agoMaybe the training of the emergency crew is not sufficient?
- tapland 7y agoBecause it's hard. I helped out at a company among many that are trying to develop a system that would allow you to do this in ambulance and they started testing prototypes 10 years ago and have yet to progress from that stage.
- drbytes 7y agoReminds me about a quote I heard, don't remember where, about Napoleons main medic. Apparently he noticed that equally injured soldiers would die at different times based upon how close they were to the camp fire with those closest expiring way before those laid out the farthest from the fire. Could be a bs story, I never actually looked into it.
- pbhjpbhj 7y agoSo then he had badly injured soldiers sit really close to the fire?
- deleted 7y ago[deleted]
- isostatic 7y agoGood job it wasn't in america, she'd have woken up, seen the bill, and had another heart attack!
- imdsm 7y agoThis is a great joke but I feel I should point out that cardiac arrests != heart attacks
- acangiano 7y agoIndeed. Survival rates: - Cardiac arrest (outside hospitals): < 6% - Cardiac arrest (inside hospitals): < 25% - Heart attack (myocardial infarction): > 90%
- MS90 7y agoGah the word "infarction" drives me crazy since it's so close to "infraction"
- toss1 7y agoYup, makes sense because although the phrase "heart attack" generally has a worse connotation, the immediate reality of a full cardiac arrest is actually much worse - the entire heart stops instead of only part of it. "In summary, there is a difference between a heart attack and a cardiac arrest. A heart attack occurs when the blood supply to part of the heart stops and thus causes a section of the heart muscle to begin to die; whereas a cardiac arrest occurs when the heart stops beating as a whole.Jun 25, 2019" [1] https://www.news-medical.net/health/Heart-attack-and-cardiac-arrest-difference.aspx https://www.news-medical.net/health/Heart-attack-and-cardiac...
- isostatic 7y agoWasn't a joke. I went to the US on business - our corporate insurance means there's a $1000 excess that we pay up front. Went to a hospital for a minor issue. At no point was there any price list shown, at the end I was asked for $390 before been given my prescription. That was the end of it I thought, sickeningly high charge for 2 minutes with a doctor, a 10p tablet, and hours of waiting around. I asked for an itemised bill, but they couldn't give me one. A few weeks later I get another bill through the post for another $390 (slightly different amount), complete with the entire bill. The whole bill was about $2k. The 10p tablet? $250. In fact they originally gave me a 50mg one for $9, then took it off the bill, then gave me 2x25mg ones for $250. I then had a $1100 "uninsured discount" which brought the total price down to just before $800. The bulk of the bill was a single line that was fairly incomprehensible but seemed to cover pointless taking my blood pressure 3 times and the 2 minute consultation with a Doctor who barely spoke to me, and renting the chair for a few hours I guess. edit: see http://imgur.com/ERjjQBil.png http://imgur.com/ERjjQBil.png The U.S. is seriously broken.
- MarkMc 7y agoDoes this suggest that humans can be put into 'hibernation' to extend their lifespan? (Edit: I mean would be possible in future if we had a better understanding of the process?) If I was rich enough I'd host a competition to extend the life of rats: Each year, whoever could demonstrate a technique to reliably extend the lifespan of a rat by at least 10% over the previous year's record would win a million dollars. I expect that the wining entry would involve putting the rats into controlled hypothermia. Over the years the maximum lifespan will grow and we may even find that we can put rats into hibernation indefinitely. It would then be a question of whether we can apply the same techniques to humans.
- jacquesm 7y agoIt mostly suggests that one person got very lucky and that there are likely important details that made the difference between 'dead' and 'mostly dead'. Hypothermia due to a low environmental temperature has already been flagged as the way to come out of various otherwise fatal situations in more or less one piece. Besides that, even if no pulse can be detected that doesn't mean there isn't a pulse, and that can make all the difference just by itself.
- MarkMc 7y agoSure, but given enough effort perhaps we can figure out what the important details are that make the difference between 'dead' and 'mostly dead'?
- jacquesm 7y agoThere are no secrets here: https://www.bbc.com/news/health-11389464 https://www.bbc.com/news/health-11389464 Just the fantasy of the life-extenders that if they figure out this one weird thing they will live forever. The body can be temporarily suspended, depending on the complexity of the creature this can be a very long time, frogs for instance can do it for weeks or even months. https://www.latimes.com/science/sciencenow/la-sci-sn-alaskan-frozen-frogs-20140723-story.html https://www.latimes.com/science/sciencenow/la-sci-sn-alaskan... The big differentiator is whether or not the water in the cells has crystallized or not, if it does it will rupture the cells and then it is game over no matter what. Other than that it is mostly a roulette game with very high stakes. There are lots of papers on frost damage to cells, too many to list here but easily searchable.
- mrandish 7y agoMany Tier 1 regional trauma centers now have the equipment to induce hypothermia on hand. Hopefully, this will become standard gear in all trauma departments
- Teandw 7y agoSome notes: - The headline is clickbait/false really. The six-hour cardiac arrest is pretty much made up/guessed. In fact, they don't know how long she was in cardiac arrest. The article actually goes on to state "how long her heart stopped for is not clear", so it's a bit odd to say she had a six-hour cardiac arrest. - The six hours timeframe actually refers to the fact that a defibrillator was used 6 hours after the emergency services were called. - It mentions that doctors are stating it's the longest cardiac arrest ever recorded in Spain. This is a very odd thing for a professional doctor to do, when they have no evidence to back that up. As a doctor, you can't just guess she was in cardiac arrest for 6 hours and record it down as being what happend. That's misleading information.
- formerdeadgirl 7y agoYep agreed they're going for sensationalism. I was in cardiac arrest for 191 minutes before they got me onto the ECMO machine which was standing in for my heart and lungs. Those times though are pretty accurate because my husband was in contact with friends and emergency services so they have a lot of data about it.
- haack 7y agoUsername checks out (also congratulations on making it!)
- phnofive 7y agoDefibrillation doesn’t jump start a stopped heart, either - article is light on accuracy...
- rolltiide 7y agoI occasionally run into people that want to deter even thinking about the idea of life saving options because of the universe/god’s plan I met the most spiritual woman who was also in a crusade against Abrahamic religions say that What a completely unfalsifiable version of logic when the “plan” could just as easily be the treatment I got through the impasse by saying it just gives people choices even if the choice is already written in stone Schrodinger’s free will
- backspace_ 7y agoThis article is all flash with little substance. They used a "specialized machine" and never once named it. As others have mentioned this sounds exactly like ecmo. Its obvious to me that they are really simplifying the situation for their readers.
- phigcch 7y agoThere's a nice research article from 2016 by doctors in northern Norway about resuscitation of frozen patients: “Nobody is dead until warm and dead”: Prolonged resuscitation is warranted in arrested hypothermic victims also in remote areas – A retrospective study from northern Norway J. Hilmo, T. Naesheim, M. Gilbert https://www.sciencedirect.com/science/article/pii/S0300957214005243 https://www.sciencedirect.com/science/article/pii/S030095721... (open access, CC licence) Same hospital and team that treated Anna Bågenholm (mentioned in other comments, https://en.wikipedia.org/wiki/Anna_B%C3%A5genholm https://en.wikipedia.org/wiki/Anna_B%C3%A5genholm), and I guess that case is part of the study.
- deleted 7y ago[deleted]
- gregd 7y agoAs someone who was once an NREMT-B in the US, we were taught that someone isn't dead, until they're cold dead. I haven't read the article yet, but I assume they kept her warm.
- gregd 7y agoI lost the ability to edit my comments. I meant to say warm dead...not cold.
- JshWright 7y agoExactly the opposite. You want to keep someone cold until their brain has had a chance to recover.
- gregd 7y agoYou're right. I corrected myself with a comment because I cannot edit my original post. That will teach me to make comments before the caffeine has kicked in.
- bloak 7y agoNot sure about that. People whose heart and lungs have stopped may survive longer if they're cold. At least that's what I heard relating to a case of a boy who was revived after spending a long time under the ice of a frozen lake/river.
- gregd 7y agoYou're absolutely right and I corrected myself with a comment. I don't know why but I can't delete my original comment nor can I edit it.
- pvaldes 7y agoI'm very proud of Spanish healthcare at this moment. We have a terrific team here. Another recent example of one of our rock star doctors involving the successful reattachment of a severed hand without blood flow for 10 hours. https://www.thinkspain.com/news-spain/30483/super-surgeon-dr-cavadas-reattaches-us-marine-s-severed-hand https://www.thinkspain.com/news-spain/30483/super-surgeon-dr...
- rkagerer 7y agoWhen I began volunteer firefighting, curiosity led me to research the longest known CPR survival cases. Here are a few more rare and incredible tales: https://web.archive.org/web/20191206164443/http://www.leapbeyond.com/Ric/CPR/CPRArticles.pdf https://web.archive.org/web/20191206164443/http://www.leapbe... If you've never taken a CPR course, sign up for one! It could save a life one day.
- ghufran_syed 7y agoOn the other hand, cooling people after return of spontaneous circulation (ROSC) does NOT seem to help in any clinically significant way: https://www.ncbi.nlm.nih.gov/pubmed/31778636 https://www.ncbi.nlm.nih.gov/pubmed/31778636
- smh58 7y agoCorrection: his complications happened Because he was at the hospital. People don't realize this. They use these cases as examples why home births are dangerous, yet ignore the fact that the hospital environment and interventions are the cause of most complications.
- a_t48 7y agoSource on your knowledge of OP’s child’s birth?
- kensai 7y agoWhat you are saying shows terrible and dangerous ignorance. I really hope you are not a vaccine denier as well. At max you could say his complications were RECOGNIZED as such because he was at the hospital. Otherwise, by laymen, they might have gone undetected. PS. I am a physician.
- WhompingWindows 7y agoDo you think the Earth is flat, too?
- nwallin 7y agoThe leading cause of death among women before modern medicine was childbirth. Childbirth without medical care is incredibly dangerous.
- thrwn_frthr_awy 7y agoMy son would be dead if was delivered at home.
- m463 7y agoA fascinating book to read is "King of Hearts: The True Story of the Maverick Who Pioneered Open Heart Surgery" by G. Wayne Miller. Early open heart surgery was pioneered with TWO patients whose circulatory systems were connected together so that patient two could could breathe and pump blood for patient one while the heart was stopped. Amazing (in a sort of blank-faced-blink-blink sort of way)