UKC

Saw this update on a rescue from Keswick MRT just now.  Absolutely astonishing story.

https://keswickmrt.org.uk/rescue/halls-fell-blencathra-2/

T.

Bloody hell. That’s some read!

Glad the guy’s ok, but only due to incredible work from the MRT and medical staff.

Like you say, astonishing stuff, thanks for sharing. 

Excellent result.  Just goes to show that the maxim that they're not dead until they're warm and dead is true!

Wow! Lucky lad!

It's possible that the bloke was hypothermic and climbed out of the survival bag because he thought he was too hot (common symptom apparently). Amazingly lucky to be found by such skilled and professional people.

I'm guessing here but maybe his body went into a "shock" mode (where pretty much everything shuts down) similar to what happens to some people who fall into very cold water and survive a long time (many minutes) underwater.

Regardless, 18.8 degC core temperature is incomprehensively low.

Amazing work by all involved for not giving up.

Indeed, as per the documentary Last Breath, which is a must watch  

Amazing - not the best descent to have a problem. Thanks for posting.

A few years ago, I saw an excellent talk by this lady (well the talk was given as a double act with one of the skiers who had been at the accident) :

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

I think it led to new recommended procedures in such cases.

Jon.

(Apologies if the link doesn't work)

Lucky guy that Keswick have an auto-pulse: not all teams do and it's a life-and-death piece of kit!

18.8C  and every other aspect is just incredible! 

Bloody hell! That's a great outcome.

You are indeed not dead until warm and dead. ECMO is also much better than ducking around with peritoneal dialysis catheters and fluid which was the old school alternative, although relatively few centres have access to ECMO. 

Our auto-pulse for the heli arrived last week  

Great result for the team there. Well done everyone involved 

b

also on the local BBC:

https://www.bbc.co.uk/news/uk-england-cumbria-61862157

Be interested to know more detail about the prevailing weather conditions and kit carried (more as a learning opportunity for myself and others!)

I don't understand 'warm and dead' - care to explain?

It means they don't give up on a hypothermic "corpse" until they've gone through a warming procedure. If there's still no heartbeat/breathing/life signs after warming, only then is death pronounced

It's been a common term for with people who drown in reservoirs - where the body sinks in to cold water - for at least a decade.  If a person dies in cold water, they can be revived after periods of death over 45 minutes in length if the sequencing of the care is right.  The meaning as I understand it is that one doesn't close out the possibility of reviving the victim until they have been carefully warmed up according to a revival protocol.  If they're recently dead and cold they may actually be in a low level sort of suspended animation. 

https://www.bbc.co.uk/news/av/stories-50630441

https://www.mypoolsigns.com/blog/bring-cold-water-drowning-victims-back-lif...

I used italics above for dies and death as one could argue the victims were in a sort of hibernation state or suspended animation rather than dead.  The nematode worm c. elegans can - following the right protocol - be stored indefinitely at -80 C and then revived.  A different nematode species was revived after 42,000 years in the ice - https://www.livescience.com/63187-siberian-permafrost-worms-revive.html 

So, perhaps it's not surprising that a human can be cooled to a point the activity, whose cessation we normally associate with death, stops yet they are not permanently dead.

The technique (ECMO) used to recover this patient is pretty invasive medicine, and unlike nematodes. we don't have a protocol to deep-freeze humans to the point life within individual cells stops allowing the whole organism to pause for more than a few hours.  Kept above zero, chemical and biological processes within the individual cells that make us up slow down meaning they don't instantly loose the ability to support whole-animal level life, but they still go off the rails over time to the point the whole animal is no longer viable.  But there's a magic window for recovery that gets longer with lower but non-frozen temperatures.  

This opens some really fascinating questions in to the nature of conscious self awareness; whatever it is, it can be interrupted by brain death and then resumed (not unlike general anaesthesia perhaps) which suggests it's a process that runs atop of physical encoded memories, and that it's total state is physically encoded and not living in the signalling patterns or some etheric whimsy.

Nah. We just reboot and reconnect with the 'universal consciousness'... <splutter>

As the guys above explain nicely - usually only applicable for people who have rapidly cooled (e.g. cold water drowning, hypothermia) and the mechanism of injury is otherwise survivable. If I fell down the Eigerwand, there would be little point warming me up to confirm I had definitely died. 

There's a (probably apocryphal) story of a South American tribe who had multiple words for dead that translate roughly as "dead", "definitely dead", and "dead forever". For this hypothermic fellow he was somewhere between the first and third....

b

From what everyone's said, it sounds to me like the thing that maybe saved this guy was that he got out of the survival bag and thereby got cold much more quickly.

I think getting out of the survival bag was the reason he got so hypothermic and had a cardiac arrest. 
 

what saved him was the professionalism of the MRT, good quality CPR keeling blood going to the brain and timely transfer to a specialist ECMO centre. 

Yep, years ago I did a mountain first aid course - back in the 90s so I know plenty of things have changed since then, but I remember being struck by them saying if you are with someone who is deeply hypothermic and needs CPR you have to be bloody willing to keep at it, and keep at it, and keep at it until the helicopter or MRT gets to you and take over. That's because if you try to resuscitate, they will keep going at hospital until the victim is warmed, and still definitely dead. It seems that the first rescuers who got to this chap did exactly that - they started and they didn't stop and the guy is alive as a result. A simply superb effort from the first rescuer who got to him, through to the medics in the hospital who saw him through to discharge. Brilliant effort.

Or maybe our overlords running the lab simulation have a use for him in the future and he couldn't be eliminated from the program just yet.

Incredible story - well done to all involved.

The best laid plans of mice....

not just in winter: https://www.theargus.co.uk/news/19129990.team-gbs-chris-smith-died-accident...

hypothermia caused 'paradoxical undressing'?

It’s been a very instructive thread.

I’m first aid at work trained and have dealt with conscious hypothermic people a few times but I’d never heard of the above. I suspect if I’d found someone like that I may have assumed they were dead and done nothing beyond calling 999.

I wonder how the lad is doing. Hopefully he hasn’t suffered anything permanently debilitating.

He was on local TV last night. I think he had some very minor nerve issues in his extremities, but seemed in remarkably good shape He is  planning to run the London marathon next year to raise funds for the MRT as a thank you 

What is your question?

Hypothermia causes impaired cognition (and possibly impaired sensory response). This causes people to do the opposite of what would be sensible; to remove warm clothing, or leave shelter. So 'paradoxical undressing' is the term commonly used to describe hypothermia victims removing clothing, worsening their condition.

The sufferer can also get extremely defensive and bolshy when this is pointed out to them, further complicating treatment. I've had to deal with one person in this state, it wasn't easy.

I'm sure you already knew that but possibly Magma didn't.

The way it was explained to me was that in moderate/severe hypothermia your body pushes all your blood to your core to protect vital organs and then as you become critically hypothermic those compensatory mechanisms fail and the blood rushes back to your extremities. So the already very confused casualty (fairly shortly before they die) suddenly feels very hot and start removing layers. I guess it must be like awful hot aches, there's a lot of reports of hypothermic mountaineers pulling off gloves

Great to hear he’s doing well. Would love to see a short documentary come out of this. Has the capacity to be gripping and informative.

I am in absolute awe of ALL mountain rescue people, none more so than in this instance.

The circumstances do make me wonder how many cases there have been whereby the subject of the rescue attempt, not necessarily solely in mountain rescue situations, have been considered dead and beyond resuscitation when, in fact, they did not come into the "warm and dead" category. We will never know.

Just re-reading Hunter Davies, a Short Walk in the Lakes, which on the whole is a good light read. But his view of MR is contemptible, and shows no understanding or empathy of what they do. (A bit like the reviewer who thought Fiva was very funny.)

Couldn't find any links. What was the gist?

I haven't got my copy in front of me at the moment, but it was along the lines that MR was 'insisting' that everyone had lots of emergency kit, everyone should wear 'proper' boots, that they were basically interfering busybodies, nanny state etc etc.

You used to see the 'never go on the fells, but if you do have the heaviest boots possible' advice a lot on MR facebook pages, but the comments were from the MR 'groupies' who probably don't do much more than walk round Keswick in a grands worth of kit from George Fisher.

It seems to have dropped off a lot now, not sure if MR are deleting the 'unofficial advice' in case it looks like they endorse it.