7 ms·

Ice water drowning survival of young patient (2025)

204 points by js2 4mo ago

mchusma 4mo ago
Incredible. I wonder if they can make progress on survivability of regular drowning.
- bsder 4mo ago
  Unlikely. The issue is cold and the speed of the cold. Children have a higher surface-to-mass ratio along with less subcutaneous fat which allows them to cool quickly. The article quotes the breakpoint: If water temperature is >6 °C (43 °F), survival is unlikely for submersion >30 minutes. And even still, it isn't like the child came out unscathed.
- zardo 4mo ago
  Ultimately the reason cold water drownings are survivable is because the lower temperature decreases the speed of chemical reactions. If chemical reactions are happening (e.g.) 10x slower, then the amount of damage that occurs 10 minutes after cessation of breathing at normal body temperature now take 100 minutes.
addaon 4mo ago
They’re not dead until they’re warm and dead.
- gcanyon 4mo ago
  I was looking for this. Didn't find it, so I posted it myself.
hannasm 4mo ago
Wim hof has a similar childhood story (maybe not quite as extreme)...
- HerbManic 4mo ago
  Wim hof has a lot of stories, hard to tell which ones are true or not unfortunately.
  - vasco 4mo ago
    I believe the stories of him being convicted of domestic abuse since that was in a court
    - attila-lendvai 4mo ago
      i did a search for this: "It includes claims that Hof was sentenced in 2012 by the Amsterdam magistrates court to community service and a fine for assaulting Caroline’s oldest son, then 18. The Amsterdam court confirmed that Hof went before the magistrates court in 2012 and was given a sentence of 40 hours of community service and fined €350. Enahm Hof said the domestic violence conviction related to “a single incident involving Caroline’s son, adult at the time, for which Wim Hof expressed regret and offered an apology. Wim clarifies that no physical violence occurred, but a struggle, which nonetheless should not have happened.” that "no physical violence occurred, but a struggle" is an oxymoron for me. maybe no physical injury...
deleted 4mo ago
[deleted]
js2 4mo ago
I was rewatching The Abyss for the first time since 1989 and wondered just what is the process for reviving an asystole heart[^1]. [^1]: It was only relatively recently that I learned you can't shock an asystole heart. e.g. https://medicalsciences.stackexchange.com/questions/5874/can-manual-external-defibrillators-restart-a-heart https://medicalsciences.stackexchange.com/questions/5874/can...
- ethersteeds 4mo ago
  CPR and a boatload of epinephrine, it seems. That passage bears quoting at length, it's where I really teared up: > At initiation of ECMO, the boy's rhythm was asystole. The boy was rewarmed with an ECMO heat exchanger-patient gradient ≤10 °C. [...] As the patient's temperature approached 22 °C (72 °F), low-frequency and low-amplitude sinusoidal electrical deflections were noted on his electrocardiogram. As the patient continued to rewarm, these phasic electrical deflections slowly increased in frequency and amplitude. At approximately 28 °C (82 °F), sinusoidal deflections organized into more classic cardiac electrical activity reminiscent of sinus bradycardia with a wide complex. Amiodarone, calcium gluconate, magnesium sulfate, bolus epinephrine, and epinephrine and norepinephrine infusions were administered. After further rewarming, sinus bradycardia developed and ultimately progressed to normal sinus rhythm...
- gcanyon 4mo ago
  Ed Harris acted the crap out of that scene. And the whole dynamic between him and Mary Elizabeth Mastrantonio in that film was awesome. I wish James Cameron was bringing that same level of characterization to Avatar :-/
usernametaken29 4mo ago
I remember that cryogenesis was deemed viable in the 80ies but essentially surface area is your enemy. Anything larger than a cat can’t be resurrected. It’s pretty bizarre really, they froze mice and microwaved them back to life.
- kombookcha 4mo ago
  Weird! I wonder if there is some exponential complexity going on. More neural pathways leaving more stuff that can potentially break from an uneven freeze/thaw? Or is it literally that the freezing and thawing can't happen evenly when you're too big? A brief transistional period with unfrozen outsides and frozen solid insides is probably not great for you.
  - HerbManic 4mo ago
    I would assume it is purely because of the mass.
  - usernametaken29 4mo ago
    > Or is it literally that the freezing and thawing can't happen evenly when you're too big? This. You literally can’t evaporate all the thawing agent out of the blood of the organism without substantial burns by sheer volume
    - kombookcha 4mo ago
      That's really interesting, thank you - do you know how this was done, like in a practical sense?
      - usernametaken29 4mo ago
        Actually I got the timing wrong, it was the 50ies, but here you go: https://pmc.ncbi.nlm.nih.gov/articles/PMC1363505/ https://pmc.ncbi.nlm.nih.gov/articles/PMC1363505/
    - OisinMoran 4mo ago
isoprophlex 4mo ago
"Survival" here being, of course, not a black-and-white thing: > Outcome and Follow-Up > On day 59, the boy was discharged to inpatient neurorehabilitation. At 6-month follow-up, he was giving short commands, standing without support, riding a tricycle, eating soft foods, and relearning simple tasks. Peripheral neuromuscular weakness continued to improve.
- rob74 4mo ago
  Yes, I already feared that when I read "the child recovered" instead of "the child fully recovered" in the summary.
  - 21asdffdsa12 4mo ago
    The dreaded "Patient survived" comes to mind, that is so nice in crime-stats and hospital-stats nowadays, but does not really communicate what "ten years writhing in agony barely held in check with massive opioid doses until death" or some vegetable limbo is actually for the individual.
qnleigh 4mo ago
That is incredible. 2.5 hours underwater, 1.5 hours of CPR. They were instructed not to start rewarming him until he could be given more comprehensive treatment at a hospital. They list 'death' as a differential diagnosis... He didn't come out unscathed though. They describe his progress: > At 6-month follow-up, he was giving short commands, standing without support, riding a tricycle, eating soft foods, and relearning simple tasks. Peripheral neuromuscular weakness continued to improve. which is quite limited for an 8-year old, but remarkable considering the circumstances.
- ekianjo 4mo ago
  at this age the chances of continuous improvement are probably decent
  - SXX 4mo ago
    More interesting question is what actual memory retention is in such a situation, but that not disclosed in a paper.
    - ekianjo 4mo ago
      you can always contact the authors to know more
tehnub 4mo ago
Reminds me of the extended description of what it might be like to drown in an ice lake in the book Stella Maris — it wouldn't be quick.
the_arun 4mo ago
Well written article. Life is a miracle. We are trying to understand it & there is more to learn everyday. I remember a couple of years ago, a 50yr patient (someone I know) was saved from a severe heart attack using induced hypothermia and recovering them slowly.
looofooo0 4mo ago
I am sceptical about the 147 minutes, the child could have still clinging onto the ice and just drowned a minute before the parents reached the pond.
- ddeck 4mo ago
  The timeline lists "Sled tracks seen to broken bond ice, EMS called" at 16:44. He was pulled from the water at 18:57. The article text further clarifies: Parents discovered sled tracks from home onto broken pond ice through which he fell. He left the house at 16:00, which is why they give the range of 147 to 177 minutes.
  - looofooo0 4mo ago
    Yes but ultimatively it could been 16:43 to 18:57 which is 134 Minutes.
    - d1sxeyes 4mo ago
      The first two reported timestamps are 16:00 and 16:30 which both fall conveniently on the half hour. This leads me to conclude that these are guesses, and could be either early or late. It seems most likely that the mother was not exactly aware of the time the child left the house. There is an incentive to minimise (to avoid it looking like a failure of supervision). What we are certain of is the 16:44 call to the EMS, so you're right, 134 minutes is the lower bound. However, it's not unreasonable to assume that the parents did not immediately call on noticing the child missing, so the gap between 'noticing missing' and 'calling EMS' is real and non-zero. The gap between 'leaving the house' and 'noticing missing' is something I'm less clear on: how did the parents 'notice' the child was missing when he was knowingly allowed to leave the house earlier? There's still a non-zero gap between 'last sighting' and 'realisation that he's missing' (i.e. he definitely wasn't missing at ~16:00, when the mother saw him leaving the house... what changed so that the parents believed he was missing at ~16:30? Was he supposed to check in with Dad and missed the check-in, etc?) Either way, a difference of ±10% doesn't really make that much impact in interpreting the results.
bedatadriven 4mo ago
There was some medical terminology that I didn't understand. The NotebookLLM podcast version is disturbingly good: https://notebooklm.google.com/notebook/21c5eddb-ada4-4726-85c0-762397b761d4/artifact/79df73cd-8e9a-4a92-8883-b9db3019e2cc https://notebooklm.google.com/notebook/21c5eddb-ada4-4726-85...
theturtlemoves 4mo ago
I'd be curious to read about 1, 2, 5, 10, 20 year follow-up. Party pooper warning. I'm afraid I don't have rose tinted glasses, due to personal experience with a family member with TBI (accident at age 16, 3 weeks in a coma). The aftereffects are profoundly destabilizing to his environment. I sometimes have quite a dark view of people's need to be a rescuer and celebrate the "alive!", when they don't have to deal with the next 40-60 years of living...
- spacedoutman 4mo ago
  I have a similar view on general anesthesia now, everyone i know(including myself) that has had operations have been permanently affected by anesthesia. Turning yourself off breaks far more than doctors realize i fear.
  - infofarmer 4mo ago
    Exacerbated by astonishing overuse for anything from a 2-minute endoscopy to a 15-minute hand surgery. The pursuit of “comfort” at the cost of fractional lobotomy.
    - noduerme 4mo ago
      You're suggesting people undergo endoscopy without anesthesia? You go first, bud.
      - lambdaone 4mo ago
        Conscious sedation, which is not the same thing as general anesthesia, is often used for endoscopy: https://www.northerncarealliance.nhs.uk/patient-information/patient-leaflets/gastroenterology-conscious-sedation-endoscopy-procedure https://www.northerncarealliance.nhs.uk/patient-information/...
        elric 4mo ago
        And sometimes it doesn't work. Patients are then given the option of going ahead without sedation, or rescheduling for general anaesthesia.
knights_gambit 4mo ago
Do you give slow CPR in these cases?
- fittingopposite 4mo ago
  Why should you? You still want to oxygenate the body as well as possible and distribute that oxygen throughout the body (primarily to the brain). The speed of the CPR is (I assume) rather related to the size of the heart (how quickly the heart refills from the veins) which is independent of temperature.
OhNoNotAgain_99 4mo ago
[dead]
hbbio 4mo ago
Reminds of Chris Lemons, who survived for 30+ minutes without oxygen at the bottom of the North Sea. Cold water (and experience, like staying calm) probably played a large part. He went back to diving a few weeks after! They made a movie about it: https://en.wikipedia.org/wiki/Last_Breath_(2019_film) https://en.wikipedia.org/wiki/Last_Breath_(2019_film)
- js2 4mo ago
  He was saturation diving on Heliox. From this reporting, it sounds like his heart didn't stop: https://www.bbc.com/news/uk-scotland-north-east-orkney-shetland-47826802 https://www.bbc.com/news/uk-scotland-north-east-orkney-shetl... He's a public speaker now (probably much less risky; I'm sure his family appreciates that): https://www.chrislemons.co.uk/ https://www.chrislemons.co.uk/
ggdG 4mo ago
> As the patient's temperature approached 22 °C (72 °F), low-frequency and low-amplitude sinusoidal electrical deflections were noted on his electrocardiogram. Dunno about you, but this does things to me.
- esseph 4mo ago
  Can you explain?
  - Dansvidania 4mo ago
    Not op, but imagine doing cpr to someone for more than an hour (btw this means multiple people taking turns because cpr is exhausting) and at some point there is a sign of feeble heart contractile activity (and hence life) It must have been a very emotional moment for the rescuers and parents if present. Edit: corrected typo
    - rsync 4mo ago
      An hour of cpr in an ALS scenario almost certainly involves a Lucas device: https://en.wikipedia.org/wiki/LUCAS_device https://en.wikipedia.org/wiki/LUCAS_device … which are commonly carried in ambulances.
      - Dansvidania 4mo ago
        TIL! thanks!
vixen99 4mo ago
Why are we not told how deep the pond was and confirm the % body submersion?
- attila-lendvai 4mo ago
  they were searching for the body.
mrtksn 4mo ago
Not the same thing of course but when our cat got sick with blood parasite, her blood turned to very diluted cranberry juice color and the body temperature dropped to almost room temperature(38C is the normal for cats) and the vet was double and triple checking the readings because it didn't make sense still being alive. After a few hours we were able to arrange a blood infusion and intensive care and by the morning she was "fine". By "fine" I mean alive, for months her character was much different. It took almost a year to return to its true behavior and enjoy the things she used to enjoy before. Even then she has much lower tolerance to unsolicited cuddling than before. The vet speculated that the low temperature was what kept her brain alive since the blood almost completely lost the ability to carry oxygen as a result of parasite attacking the blood cells(her initial symptoms were shortness of breath).
matsemann 4mo ago
Something similar happened recently in Norway. A tourist was found severely cold in the mountains, in a storm where extracting him took hours. After a while hypothermia got to him, his heart stopped, and only 8 hours later they got it starting again, was technically dead for 20 hours. In this case, it looks to have gone well with the person afterwards. They say you're not dead until you're warm and dead. News article https://www-nrk-no.translate.goog/vestland/nye-tal_-turgaaren-pa-hardangervidda-var-teknisk-dod-i-over-20-timar-1.17825009?_x_tr_sl=no&_x_tr_tl=en&_x_tr_hl=no&_x_tr_pto=wapp https://www-nrk-no.translate.goog/vestland/nye-tal_-turgaare... Recount of the story https://www-nrk-no.translate.goog/vestland/xl/turgaaren-var-dod-i-over-atte-timar.-no-gar-historia-fra-hardangervidda-verda-rundt-1.17660332?_x_tr_sl=no&_x_tr_tl=en&_x_tr_hl=no&_x_tr_pto=wapp https://www-nrk-no.translate.goog/vestland/xl/turgaaren-var-...
- lukan 4mo ago
  "They say you're not dead until you're warm and dead." Actual mountain rescuer slogan/wisdom.
  - FireBeyond 4mo ago
    Same thing I taught my paramedic and EMT students.
    - scarecrowbob 4mo ago
      I read it two days ago in the textbook for the EMS course that I am working through right now.
- dzhiurgis 4mo ago
  Wonder at which point we'll start adding PLB / airtags to clothing themselves. Decent jacket already cost way more than electronics. Satellite communications approaching cost of 0. If you venturing somewhere risky - kinda makes sense to have PLB built in.
  - wernerb 4mo ago
echoangle 4mo ago
As a layman, it’s kind of surprising that they attempted to CPR someone that long in this situation. If I pulled someone out of the water 2h after they went missing and they were cold to the touch, I would probably call the police and wouldn’t even ask for an ambulance.
- spuz 4mo ago
  The article describes their decision making process: > As rescue divers searched for the boy's body, we deliberated whether to attempt resuscitation and likelihood of meaningful neurologic recovery of a child submerged for at least 90 minutes. We reviewed literature for guidance2-4,6 and drew from institutional experience with a 2-year-old submerged in ice water for 40 minutes who received 101 minutes of CPR.3 The toddler recovered with no sequelae. For our current patient, the decision was made to resuscitate and rewarm the boy because of his young age and protective effects of ice water submersion. We reasoned that if meaningful neurologic function were not observed after rewarming, end-organ preservation on ECMO may allow family goodbyes and organ harvest for transplantation to give other sick children the gift of life.9 This important point should be considered by providers faced with the difficult decision to attempt resuscitation of a patient with asystolic hypothermia >90 minutes.
- kombookcha 4mo ago
  I believe this is common to attempt when dealing with very cold water drownings. Obviously this is a very extreme case, but I believe you'd generally be instructed on the phone to start CPR but not try to heat them up until the ambulance arrives. Just in case. The case below had a person conscious in the water for 40 minutes (with an air pocket under the ice) before going into circulatory arrest, and then spent another 40 minutes clinically dead in under water. The combined 80 minutes in the water lowered her body temperature very dramatically, and played a large part in her almost complete recovery. https://en.wikipedia.org/wiki/Anna_B%C3%A5genholm https://en.wikipedia.org/wiki/Anna_B%C3%A5genholm
- stymaar 4mo ago
  There's been plenty of previous evidence that cold water immersion significantly slows down the destructive process caused by hypoxia in the brain. I don't think they'd have tried that had the boy stayed in a heated swimming pool for two hours.
Ha1zyydev 4mo ago
[flagged]
momoraul 4mo ago
147 minutes under and they brought him back. Every time I read a cold-water survival case I'm amazed all over again at what the body can pull through.
TacticalCoder 4mo ago
Which is why some doctors/scientist explained --and it's been at least tested but I don't know if they managed to get enough data to confirm-- that in ambulances there should always be ice and a device to put all around the head, to keep the head cool with the ice. Not only for survival but to lower the risk of permanent brain damage after incidents. It's nothing new and I wonder when it's going to be taken more seriously as an emergency response as obviously there is something going on here.
gcanyon 4mo ago
As the say goes, "you're not dead until you're WARM and dead." Still, that recovery sounds rough on everyone involved.
cassepipe 4mo ago
https://en.wikipedia.org/wiki/Anna_B%C3%A5genholm https://en.wikipedia.org/wiki/Anna_B%C3%A5genholm
pxeger1 4mo ago
How many people have died because the people who could've saved them didn't think it was possible to save them?

204 points by js2 4mo ago

mchusma 4mo ago

Incredible. I wonder if they can make progress on survivability of regular drowning.

bsder 4mo ago
Unlikely. The issue is cold and the speed of the cold. Children have a higher surface-to-mass ratio along with less subcutaneous fat which allows them to cool quickly. The article quotes the breakpoint: If water temperature is >6 °C (43 °F), survival is unlikely for submersion >30 minutes. And even still, it isn't like the child came out unscathed.
zardo 4mo ago
Ultimately the reason cold water drownings are survivable is because the lower temperature decreases the speed of chemical reactions. If chemical reactions are happening (e.g.) 10x slower, then the amount of damage that occurs 10 minutes after cessation of breathing at normal body temperature now take 100 minutes.

addaon 4mo ago

They’re not dead until they’re warm and dead.

gcanyon 4mo ago
I was looking for this. Didn't find it, so I posted it myself.

hannasm 4mo ago

Wim hof has a similar childhood story (maybe not quite as extreme)...

HerbManic 4mo ago
Wim hof has a lot of stories, hard to tell which ones are true or not unfortunately.
- vasco 4mo ago
  I believe the stories of him being convicted of domestic abuse since that was in a court
  - attila-lendvai 4mo ago
    i did a search for this: "It includes claims that Hof was sentenced in 2012 by the Amsterdam magistrates court to community service and a fine for assaulting Caroline’s oldest son, then 18. The Amsterdam court confirmed that Hof went before the magistrates court in 2012 and was given a sentence of 40 hours of community service and fined €350. Enahm Hof said the domestic violence conviction related to “a single incident involving Caroline’s son, adult at the time, for which Wim Hof expressed regret and offered an apology. Wim clarifies that no physical violence occurred, but a struggle, which nonetheless should not have happened.” that "no physical violence occurred, but a struggle" is an oxymoron for me. maybe no physical injury...

deleted 4mo ago

[deleted]

js2 4mo ago

I was rewatching The Abyss for the first time since 1989 and wondered just what is the process for reviving an asystole heart[^1]. [^1]: It was only relatively recently that I learned you can't shock an asystole heart. e.g. https://medicalsciences.stackexchange.com/questions/5874/can-manual-external-defibrillators-restart-a-heart https://medicalsciences.stackexchange.com/questions/5874/can...

ethersteeds 4mo ago
CPR and a boatload of epinephrine, it seems. That passage bears quoting at length, it's where I really teared up: > At initiation of ECMO, the boy's rhythm was asystole. The boy was rewarmed with an ECMO heat exchanger-patient gradient ≤10 °C. [...] As the patient's temperature approached 22 °C (72 °F), low-frequency and low-amplitude sinusoidal electrical deflections were noted on his electrocardiogram. As the patient continued to rewarm, these phasic electrical deflections slowly increased in frequency and amplitude. At approximately 28 °C (82 °F), sinusoidal deflections organized into more classic cardiac electrical activity reminiscent of sinus bradycardia with a wide complex. Amiodarone, calcium gluconate, magnesium sulfate, bolus epinephrine, and epinephrine and norepinephrine infusions were administered. After further rewarming, sinus bradycardia developed and ultimately progressed to normal sinus rhythm...
gcanyon 4mo ago
Ed Harris acted the crap out of that scene. And the whole dynamic between him and Mary Elizabeth Mastrantonio in that film was awesome. I wish James Cameron was bringing that same level of characterization to Avatar :-/

usernametaken29 4mo ago

I remember that cryogenesis was deemed viable in the 80ies but essentially surface area is your enemy. Anything larger than a cat can’t be resurrected. It’s pretty bizarre really, they froze mice and microwaved them back to life.

kombookcha 4mo ago
Weird! I wonder if there is some exponential complexity going on. More neural pathways leaving more stuff that can potentially break from an uneven freeze/thaw? Or is it literally that the freezing and thawing can't happen evenly when you're too big? A brief transistional period with unfrozen outsides and frozen solid insides is probably not great for you.
- HerbManic 4mo ago
  I would assume it is purely because of the mass.
- usernametaken29 4mo ago
  > Or is it literally that the freezing and thawing can't happen evenly when you're too big? This. You literally can’t evaporate all the thawing agent out of the blood of the organism without substantial burns by sheer volume
  - kombookcha 4mo ago
    That's really interesting, thank you - do you know how this was done, like in a practical sense?
    - usernametaken29 4mo ago
      Actually I got the timing wrong, it was the 50ies, but here you go: https://pmc.ncbi.nlm.nih.gov/articles/PMC1363505/ https://pmc.ncbi.nlm.nih.gov/articles/PMC1363505/
  - OisinMoran 4mo ago

isoprophlex 4mo ago

"Survival" here being, of course, not a black-and-white thing: > Outcome and Follow-Up > On day 59, the boy was discharged to inpatient neurorehabilitation. At 6-month follow-up, he was giving short commands, standing without support, riding a tricycle, eating soft foods, and relearning simple tasks. Peripheral neuromuscular weakness continued to improve.

rob74 4mo ago
Yes, I already feared that when I read "the child recovered" instead of "the child fully recovered" in the summary.
- 21asdffdsa12 4mo ago
  The dreaded "Patient survived" comes to mind, that is so nice in crime-stats and hospital-stats nowadays, but does not really communicate what "ten years writhing in agony barely held in check with massive opioid doses until death" or some vegetable limbo is actually for the individual.

qnleigh 4mo ago

That is incredible. 2.5 hours underwater, 1.5 hours of CPR. They were instructed not to start rewarming him until he could be given more comprehensive treatment at a hospital. They list 'death' as a differential diagnosis... He didn't come out unscathed though. They describe his progress: > At 6-month follow-up, he was giving short commands, standing without support, riding a tricycle, eating soft foods, and relearning simple tasks. Peripheral neuromuscular weakness continued to improve. which is quite limited for an 8-year old, but remarkable considering the circumstances.

ekianjo 4mo ago
at this age the chances of continuous improvement are probably decent
- SXX 4mo ago
  More interesting question is what actual memory retention is in such a situation, but that not disclosed in a paper.
  - ekianjo 4mo ago
    you can always contact the authors to know more

tehnub 4mo ago

Reminds me of the extended description of what it might be like to drown in an ice lake in the book Stella Maris — it wouldn't be quick.

the_arun 4mo ago

Well written article. Life is a miracle. We are trying to understand it & there is more to learn everyday. I remember a couple of years ago, a 50yr patient (someone I know) was saved from a severe heart attack using induced hypothermia and recovering them slowly.

looofooo0 4mo ago

I am sceptical about the 147 minutes, the child could have still clinging onto the ice and just drowned a minute before the parents reached the pond.

ddeck 4mo ago
The timeline lists "Sled tracks seen to broken bond ice, EMS called" at 16:44. He was pulled from the water at 18:57. The article text further clarifies: Parents discovered sled tracks from home onto broken pond ice through which he fell. He left the house at 16:00, which is why they give the range of 147 to 177 minutes.
- looofooo0 4mo ago
  Yes but ultimatively it could been 16:43 to 18:57 which is 134 Minutes.
  - d1sxeyes 4mo ago
    The first two reported timestamps are 16:00 and 16:30 which both fall conveniently on the half hour. This leads me to conclude that these are guesses, and could be either early or late. It seems most likely that the mother was not exactly aware of the time the child left the house. There is an incentive to minimise (to avoid it looking like a failure of supervision). What we are certain of is the 16:44 call to the EMS, so you're right, 134 minutes is the lower bound. However, it's not unreasonable to assume that the parents did not immediately call on noticing the child missing, so the gap between 'noticing missing' and 'calling EMS' is real and non-zero. The gap between 'leaving the house' and 'noticing missing' is something I'm less clear on: how did the parents 'notice' the child was missing when he was knowingly allowed to leave the house earlier? There's still a non-zero gap between 'last sighting' and 'realisation that he's missing' (i.e. he definitely wasn't missing at ~16:00, when the mother saw him leaving the house... what changed so that the parents believed he was missing at ~16:30? Was he supposed to check in with Dad and missed the check-in, etc?) Either way, a difference of ±10% doesn't really make that much impact in interpreting the results.

bedatadriven 4mo ago

There was some medical terminology that I didn't understand. The NotebookLLM podcast version is disturbingly good: https://notebooklm.google.com/notebook/21c5eddb-ada4-4726-85c0-762397b761d4/artifact/79df73cd-8e9a-4a92-8883-b9db3019e2cc https://notebooklm.google.com/notebook/21c5eddb-ada4-4726-85...

theturtlemoves 4mo ago

I'd be curious to read about 1, 2, 5, 10, 20 year follow-up. Party pooper warning. I'm afraid I don't have rose tinted glasses, due to personal experience with a family member with TBI (accident at age 16, 3 weeks in a coma). The aftereffects are profoundly destabilizing to his environment. I sometimes have quite a dark view of people's need to be a rescuer and celebrate the "alive!", when they don't have to deal with the next 40-60 years of living...

spacedoutman 4mo ago
I have a similar view on general anesthesia now, everyone i know(including myself) that has had operations have been permanently affected by anesthesia. Turning yourself off breaks far more than doctors realize i fear.
- infofarmer 4mo ago
  Exacerbated by astonishing overuse for anything from a 2-minute endoscopy to a 15-minute hand surgery. The pursuit of “comfort” at the cost of fractional lobotomy.
  - noduerme 4mo ago
    You're suggesting people undergo endoscopy without anesthesia? You go first, bud.
    - lambdaone 4mo ago
      Conscious sedation, which is not the same thing as general anesthesia, is often used for endoscopy: https://www.northerncarealliance.nhs.uk/patient-information/patient-leaflets/gastroenterology-conscious-sedation-endoscopy-procedure https://www.northerncarealliance.nhs.uk/patient-information/...
      - elric 4mo ago
        And sometimes it doesn't work. Patients are then given the option of going ahead without sedation, or rescheduling for general anaesthesia.

knights_gambit 4mo ago

Do you give slow CPR in these cases?

fittingopposite 4mo ago
Why should you? You still want to oxygenate the body as well as possible and distribute that oxygen throughout the body (primarily to the brain). The speed of the CPR is (I assume) rather related to the size of the heart (how quickly the heart refills from the veins) which is independent of temperature.

OhNoNotAgain_99 4mo ago

[dead]

hbbio 4mo ago

Reminds of Chris Lemons, who survived for 30+ minutes without oxygen at the bottom of the North Sea. Cold water (and experience, like staying calm) probably played a large part. He went back to diving a few weeks after! They made a movie about it: https://en.wikipedia.org/wiki/Last_Breath_(2019_film) https://en.wikipedia.org/wiki/Last_Breath_(2019_film)

js2 4mo ago
He was saturation diving on Heliox. From this reporting, it sounds like his heart didn't stop: https://www.bbc.com/news/uk-scotland-north-east-orkney-shetland-47826802 https://www.bbc.com/news/uk-scotland-north-east-orkney-shetl... He's a public speaker now (probably much less risky; I'm sure his family appreciates that): https://www.chrislemons.co.uk/ https://www.chrislemons.co.uk/

ggdG 4mo ago

> As the patient's temperature approached 22 °C (72 °F), low-frequency and low-amplitude sinusoidal electrical deflections were noted on his electrocardiogram. Dunno about you, but this does things to me.

esseph 4mo ago
Can you explain?
- Dansvidania 4mo ago
  Not op, but imagine doing cpr to someone for more than an hour (btw this means multiple people taking turns because cpr is exhausting) and at some point there is a sign of feeble heart contractile activity (and hence life) It must have been a very emotional moment for the rescuers and parents if present. Edit: corrected typo
  - rsync 4mo ago
    An hour of cpr in an ALS scenario almost certainly involves a Lucas device: https://en.wikipedia.org/wiki/LUCAS_device https://en.wikipedia.org/wiki/LUCAS_device … which are commonly carried in ambulances.
    - Dansvidania 4mo ago
      TIL! thanks!

vixen99 4mo ago

Why are we not told how deep the pond was and confirm the % body submersion?

attila-lendvai 4mo ago
they were searching for the body.

mrtksn 4mo ago

Not the same thing of course but when our cat got sick with blood parasite, her blood turned to very diluted cranberry juice color and the body temperature dropped to almost room temperature(38C is the normal for cats) and the vet was double and triple checking the readings because it didn't make sense still being alive. After a few hours we were able to arrange a blood infusion and intensive care and by the morning she was "fine". By "fine" I mean alive, for months her character was much different. It took almost a year to return to its true behavior and enjoy the things she used to enjoy before. Even then she has much lower tolerance to unsolicited cuddling than before. The vet speculated that the low temperature was what kept her brain alive since the blood almost completely lost the ability to carry oxygen as a result of parasite attacking the blood cells(her initial symptoms were shortness of breath).

matsemann 4mo ago

Something similar happened recently in Norway. A tourist was found severely cold in the mountains, in a storm where extracting him took hours. After a while hypothermia got to him, his heart stopped, and only 8 hours later they got it starting again, was technically dead for 20 hours. In this case, it looks to have gone well with the person afterwards. They say you're not dead until you're warm and dead. News article https://www-nrk-no.translate.goog/vestland/nye-tal_-turgaaren-pa-hardangervidda-var-teknisk-dod-i-over-20-timar-1.17825009?_x_tr_sl=no&_x_tr_tl=en&_x_tr_hl=no&_x_tr_pto=wapp https://www-nrk-no.translate.goog/vestland/nye-tal_-turgaare... Recount of the story https://www-nrk-no.translate.goog/vestland/xl/turgaaren-var-dod-i-over-atte-timar.-no-gar-historia-fra-hardangervidda-verda-rundt-1.17660332?_x_tr_sl=no&_x_tr_tl=en&_x_tr_hl=no&_x_tr_pto=wapp https://www-nrk-no.translate.goog/vestland/xl/turgaaren-var-...

lukan 4mo ago
"They say you're not dead until you're warm and dead." Actual mountain rescuer slogan/wisdom.
- FireBeyond 4mo ago
  Same thing I taught my paramedic and EMT students.
  - scarecrowbob 4mo ago
    I read it two days ago in the textbook for the EMS course that I am working through right now.
dzhiurgis 4mo ago
Wonder at which point we'll start adding PLB / airtags to clothing themselves. Decent jacket already cost way more than electronics. Satellite communications approaching cost of 0. If you venturing somewhere risky - kinda makes sense to have PLB built in.
- wernerb 4mo ago

echoangle 4mo ago

As a layman, it’s kind of surprising that they attempted to CPR someone that long in this situation. If I pulled someone out of the water 2h after they went missing and they were cold to the touch, I would probably call the police and wouldn’t even ask for an ambulance.

spuz 4mo ago
The article describes their decision making process: > As rescue divers searched for the boy's body, we deliberated whether to attempt resuscitation and likelihood of meaningful neurologic recovery of a child submerged for at least 90 minutes. We reviewed literature for guidance2-4,6 and drew from institutional experience with a 2-year-old submerged in ice water for 40 minutes who received 101 minutes of CPR.3 The toddler recovered with no sequelae. For our current patient, the decision was made to resuscitate and rewarm the boy because of his young age and protective effects of ice water submersion. We reasoned that if meaningful neurologic function were not observed after rewarming, end-organ preservation on ECMO may allow family goodbyes and organ harvest for transplantation to give other sick children the gift of life.9 This important point should be considered by providers faced with the difficult decision to attempt resuscitation of a patient with asystolic hypothermia >90 minutes.
kombookcha 4mo ago
I believe this is common to attempt when dealing with very cold water drownings. Obviously this is a very extreme case, but I believe you'd generally be instructed on the phone to start CPR but not try to heat them up until the ambulance arrives. Just in case. The case below had a person conscious in the water for 40 minutes (with an air pocket under the ice) before going into circulatory arrest, and then spent another 40 minutes clinically dead in under water. The combined 80 minutes in the water lowered her body temperature very dramatically, and played a large part in her almost complete recovery. https://en.wikipedia.org/wiki/Anna_B%C3%A5genholm https://en.wikipedia.org/wiki/Anna_B%C3%A5genholm
stymaar 4mo ago
There's been plenty of previous evidence that cold water immersion significantly slows down the destructive process caused by hypoxia in the brain. I don't think they'd have tried that had the boy stayed in a heated swimming pool for two hours.

Ha1zyydev 4mo ago

[flagged]

momoraul 4mo ago

147 minutes under and they brought him back. Every time I read a cold-water survival case I'm amazed all over again at what the body can pull through.

TacticalCoder 4mo ago

Which is why some doctors/scientist explained --and it's been at least tested but I don't know if they managed to get enough data to confirm-- that in ambulances there should always be ice and a device to put all around the head, to keep the head cool with the ice. Not only for survival but to lower the risk of permanent brain damage after incidents. It's nothing new and I wonder when it's going to be taken more seriously as an emergency response as obviously there is something going on here.

gcanyon 4mo ago

As the say goes, "you're not dead until you're WARM and dead." Still, that recovery sounds rough on everyone involved.

cassepipe 4mo ago

https://en.wikipedia.org/wiki/Anna_B%C3%A5genholm https://en.wikipedia.org/wiki/Anna_B%C3%A5genholm

pxeger1 4mo ago

How many people have died because the people who could've saved them didn't think it was possible to save them?