British woman revived after six-hour of hypothermic cardiac arrest

India

healthysoch

New Delhi, December 07, 2019 :

In the last two years we saw two cases of premature new-borns who were declared dead and got revived spontaneously with the effect of some contact warm atmosphere. Both cases created a hue and cry in the media.

Many cases are on record when people got up after death in the cremation ground. The scientific fact is low body temperatures preserves the brain and these people can be revived with CPR and defibrillation after bringing the temperature up. The lesson is never miss hypothermia before declaring death,

There is an AYIUSH saying Sir Thanda, peat naram and par garam [ head should be cold, abdomen should be soft, and foot should be warm]. If their feet are cold never stop CPR.

Now doctors in Barcelona have revived a British woman after six-hour cardiac arrest after developing natural hypothermia while hiking in the Catalan Pyrenees in freezing weather last month.

Around lunchtime, after the temperature dropped and it began to snow, Schoeman noticed that his wife was speaking oddly and becoming incoherent. Shortly afterwards, she stopped moving and fell unconscious. He rang friends, who helped firefighters and rescuers locate them and launch a helicopter rescue operation. But bad weather delayed the rescue and by the time they reached the pair, it was 3.30pm. By that point, Mash had severe hypothermia and her body temperature had fallen to just 18C (64.4 F); normal body temperature is 37C. She was then taken by helicopter to the Vall d’Hebron hospital in Barcelona, which has an extracorporeal membrane oxygenation machine (Ecmo).

But by 9.45pm, Mash’s body temperature had risen to 30C (86F) and the doctors tried again to successfully revive her, using a defibrillator.

Facts :

1. Hypothermia is defined as a core temperature below 35°C (95°F), and can be further classified by severity
2. Mild hypothermia: core temperature 32 to 35°C (90 to 95°F); findings include confusion, tachycardia, and increased shivering.
3. Moderate hypothermia: 28 to 32°C (82 to 90°F); findings include lethargy, bradycardia and arrhythmia, decreased or absent pupillary reflexes, and decreased or absent shivering.
4. Severe hypothermia: below 28°C (82°F); findings include coma, hypotension, arrhythmia, pulmonary oedema, and rigidity.
5. Rough handling of the moderate or severe hypothermic patient can precipitate arrhythmias, including ventricular fibrillation, that are often unresponsive to defibrillation and medications.

6. Cardiopulmonary resuscitation (CPR) should continue until the patient is rewarmed to 30 to 32°C (86 to 90°F), at which point renewed attempts at defibrillation and resuscitation with ACLS medications are undertaken. The neuroprotective effects of low temperature may allow recovery following prolonged arrest.

Autor : Dr KK Aggarwal , President CMAAO and HCFI