Good neurological outcome after accidental hyopthermia presenting with asytole.
A 43-year-old woman became exhausted and fainted on descent at 1127 MAMSL altitude and snowfall. A rescue team diagnosed asystole. With manual cardiopulmonary resuscitation (CPR) she was transported to the next extracorporeal life support (ECLS) center. Admission temperature was 20.7 °C. CPR continued until ECLS was initiated. Two days later she was awake, orientated, and with no neurological deficits. With hypothermic cardiac arrest, a favorable outcome depends on early continuous CPR, triage, and ECLS rewarming. It holds true that "nobody is dead until they are warmed and dead" if one cools first and arrests thereafter.
Abteilung für Anästhesiologie, Schmerztherapie und Rettungsmedizin, Ospidal - Gesundheitszentrum Unterengadin, Via Ospidal, 7550, Scuol, Switzerland.
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Klinik für Anästhesiologie, Intensiv-, Rettungs- und Schmerzmedizin, Kantonsspital St. Gallen, St. Gallen, Switzerland.|Schweizerische Rettungsflugwacht (Rega), Zürich-Flughafen, Zürich, Switzerland.
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Abteilung für Anästhesie und Intensivmedizin, Krankenhaus der Barmherzigen Brüder, Salzburg, Austria.|Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, Queen Mary University of London, London, UK.|International Commission for Mountain Emergency Medicine (ICAR MEDCOM), Zürich, Switzerland.
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Abteilung für Anästhesiologie, Schmerztherapie und Rettungsmedizin, Ospidal - Gesundheitszentrum Unterengadin, Via Ospidal, 7550, Scuol, Switzerland. joachim.koppenberg@cseb.ch.|Schweizerische Rettungsflugwacht (Rega), Zürich-Flughafen, Zürich, Switzerland. joachim.koppenberg@cseb.ch.
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D000328:Adult; D017732:Air Ambulances; D002315:Cardiopulmonary Bypass; D016887:Cardiopulmonary Resuscitation; D017548:Echocardiography, Transesophageal; D015199:Extracorporeal Membrane Oxygenation; D005260:Female; D006323:Heart Arrest; D006801:Humans; D007035:Hypothermia / Q000000981:diagnostic imaging / Q000628:therapy*; D009422:Nervous System Diseases / Q000000981:diagnostic imaging / Q000209:etiology*; D017694:Rewarming
Accidental; Cardiac arrest; Cardiopulmonary bypass; Cardiopulmonary resuscitation; Hypothermia; Rewarming