A Medical Miracle

<br><EM>BUDDHA BASNYAT, MD</EM>

June 11, 2012, 5:45 p.m. Published in Magazine Issue: Vol.: 06 No. -01 June. 08-2012 (Jestha 26, 2069)<br>

Hypothermia ( cold body temperatures) is potentially a dangerous problem. This is also a common problem in the mountains in Nepal if you are not suitably dressed for travel at high altitude in the Himalayas.  In the mountains it can be deceptively hot and humid with the sun shining down in the day time, and then once the sun goes behind the mountains in the evening, the temperature can drop to freezing.  Many sojourners ( Nepalis and tourists) come to these mountains unprepared.  Amazingly, they think it unnecessary to pack warm clothing like a down jacket only to suffer from gradual hypothermia.  You don’t have to fall into an icy cold pond to suffer from sudden hypothermia. It can be a gradual process too where over days your body temperature declines. The dramatic story of hypothermia presented below is to highlight the effects of this condition. But it is also a story of how a miracle was performed in a random hospital in the West.


This story about rescue of a three year old girl who fell into an icy fishy pond in a little village in the Austrian Alps defies belief. The parents frantically jumped into the pool, and it was a full thirty minutes before  they found her at the bottom of the pool and brought her up and started CPR ( cardiopulmonary resuscitation). When the rescue team arrived in eight minutes, her body temperature was 66 degrees, she had no pulse or blood pressure, her lungs were filled with water. Her pupils were dilated and unreactive to light indicating brain death.


Despite these findings, they continued CPR with a medic straddling her on the gurney pumping her chest and a helicopter took her to a nearest hospital. They put her on a heart lung machine at the hospital and controlled her oxygen and temperature through the system. After two hours her body temperature rose and her heart began to beat. Throughout the day and night her physicians in the intensive care unit of the hospital  suctioned off the water and the pond debris from her lungs with a fiberoptic bronchoscope. Next day they finally put her on a mechanical ventilator.


In the next few days all her organs ( heart, kidneys, intestines, lungs) remarkably recovered. Except the brain. The doctors did a CT scan and discovered a generalized brain swelling which suggested no focal pathology. Amazingly, as though what had already been done was not enough, the team drilled a hole into her skull and put a probe in to monitor brain pressures based on which they were better able to deliver drugs and fluids to the body.


Then the miracle happened in the next few days. Her pupils started to react to light; she began to breathe on her own; and she started speaking in a thick and slurry voice. Two weeks after the accident she was home. She received extensive physiotherapy, but by age five, she was normal child again.


Three things stand out. How severe hypothermia (a potential problem in our Himalayas) sustained in the icy fishpond effectively shut down the body, and the caregivers realizing this important fact went all out by initially continuing  CPR. Second, how efficiently a child’s body as opposed to an old man’s responds to prompt therapy. Third when well coordinated a random hospital in the West can indeed perform miracles.

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