Morbid Fact Du Jour for November 1, 2015

Today’s Hypothermic Yet Truly Morbid Fact!

You may recall that during yesterday’s fact a poor unfortunate soul was freezing to death when he foolishly tried to ski to a friend’s cabin after his Jeep got stuck in a snowbank. Now we find out if he lives or dies, as culled from: Last Breath: Cautionary Tales from the Limits of Human Endurance.

There’s an adage about hypothermia: “You aren’t dead until you’re warm and dead.” This points out the importance of attempting to warm and revive seemingly dead victims, for despite all appearances to the contrary, they might still retain the spark of life.

At about 6:00 the next morning, his friends, having discovered the stalled Jeep, find him, still huddled inches from the buried log, his gloveless hand shoved into his armpit. The flesh of his limbs is waxy and  stiff as old putty, his pulse nonexistent, his pupils unresponsive to light. Dead.

But those who understand cold know that even as it deadens, it offers perverse salvation. Heat is a presence: the rapid vibrating of molecules. Cold is an absence: the damping of the vibrations. At absolute zero, -459.67 degrees Fahrenheit, molecular motion ceases altogether. In the human body, cold shuts down metabolism. The lungs take in less oxygen, the heart pumps less blood. Under normal temperatures, this would produce brain damage. But the chilled brain, having slowed its own metabolism, needs far less oxygen-rich blood and can, under the right circumstances, survive intact.

Setting her ear to his chest, one of his rescuers listens intently. Seconds pass. Then , faintly, she hears a tiny sound – a single thump, so slight that it might be the sound of her own blood. She presses her ear harder to the cold flesh. Another faint thump, then another.

The slowing that accompanies freezing is, in its way, so beneficial that it is even induced at times. Cardiac surgeons often use deep chilling to slow a patient’s metabolism in preparation for surgical procedures. In this state of near suspension, the patient’s blood flows slowly, his heart rarely beats – or, in the case of those on heart-lung machines, doesn’t beat at all; death seems near. But carefully monitored, a patient can remain in this cold stasis, undamaged, for hours.

The rescuers quickly wrap their friend’s naked torso with a spare parka, his hands with mittens, his entire body with a bivvy sack. They brush snow from his pasty, frozen face. Then one snakes down through the forest to the nearest cabin. The others, left in the predawn darkness, huddle against him as silence closes around them.

With a “one, two, three,” the doctor and nurses slide the man’s stiff, curled form into a table fitted with a mattress filled with warm water that will be regularly reheated. They’d been warned that they had a profound hypothermia case coming in. Usually such victims can be straightened from their tortured fetal positions. This one can’t.

Technicians scissor with stainless-steel shears at the man’s urine-soaked long underwear and shell pants, frozen together like corrugated cardboard. They attach heart-monitor electrodes to his chest and insert a low-temperature electronic thermometer into his rectum. Digital readings flash: 24 beats per minute and a core temperature of 79.2 degrees.

The doctor shakes his head. He can’t remember seeing numbers so low. He’s not quite sure how to revive this man without killing him.

In fact, many hypothermia victims die each year in the process of being rescued. In what’s called rewarming shock, the constricted capillaries reopen almost all at once, causing a sudden drop in blood pressure. The slightest movement can send a victim’s heart muscle into wild spasms of ventricular fibrillation. In 1980, sixteen ship-wrecked Danish fisherman were hauled to safety after an hour and a half in the frigid North Sea. They then walked across the deck of the rescue ship, stepped below for a hot drink, and dropped dead, all sixteen of them.

“Seventy-eight-point-nine,” a technician calls out. “That’s three-tenths down.”

The patient is now experiencing after-drop, in which residual cold close to the body’s surface continues to cool the core even after the victim is removed from the outdoors.

The doctor rapidly issues orders to his staff: intravenous administration of warm saline, the bag first heated in the microwave to 110 degrees. Elevating the core temperature of an average-size male 1 degree requires adding about 60 kilocalories of heat. Even the warm saline, infused directly into his blood, will add only 30 kilocalories.

Ideally, the doctor would have access to a cardiopulmonary bypass machine, with which he could pump out the victim’s blood, warm and oxygenate it, and pump it back in again, safely raising the core temperate as much as 1 degree every three minutes. But such machines are rarely available outside of major urban hospitals.

“Get me the peritoneal dialysis setup,” he calls out.

Moments later, he’s sliding a large catheter into an incision in the man’s abdominal cavity. Warm fluid begins to flow from a suspended bag, washing through his abdomen, and draining out through another catheter placed in another incision. A catheter is inserted into his bladder, and warm fluid from another suspended bag flows into it.

For another hour, nurses and EMT’s hover around the edges of the table where the patient lies centered in a warm pool of light. And slowly the patient responds. Another liter of saline is added to the IV. The man’s blood pressure remains far too low, brought down by the blood flowing out to the fast-opening capillaries of his limbs. But every fifteen or twenty minutes, his temperature rises another degree.

From somewhere far away in the immense, cold darkness, you hear a faint insistent hum. Quickly it mushrooms into a ball of sound, like a planet rushing toward you, and then it becomes a stream of words.

A voice is calling your name.

You don’t want to open your eyes. You sense heat and light playing against your eyelids, but beneath their warm dance a chill wells up inside you from the sunless ocean bottoms and the farthest depths of space. You are too tired even to shiver. You want only to sleep.

“Can you hear me?”

You force open your eyes. Lights glare overheard,. Around the lights faces hover atop uniformed bodies. You try to think: You’ve been away a very long time, but where have you been?

“You’re at the hospital. You got caught in the cold.”

You try to nod. Your neck muscles feel rusted shut, unused for years. They respond to your command with only a slight twitch.

“You’ll probably have amnesia,” the voice says.

You remember the moon shining over the spiky ridge top and skiing up toward it, toward someplace warm beneath the frozen moon. After that, nothing – only that immense coldness lodged inside you.

“We’re trying to get a little warmth back into you,” the voice says.

You’d nod if you could. But you can’t move. All you can feel is throbbing discomfort everywhere. Glancing down to where the pain is most biting, you notice blisters filled with clear fluid dotting your fingers, once gloveless in the snow. During the long, cold hours the tissue froze and ice crystals formed in the tiny spaces between your cells, sucking water from them, blocking the blood supply. You stare at them absently.

“I think they’ll be fine,” a voice from overheard says. “The damage looks superficial. We expect that the blisters will break in a week or two and the tissue should revive after that.”

If not, you know that your fingers will eventually turn black, the color of bloodless, dead tissue. And then they will be amputated.

But worry slips from you as another wave of exhaustion sweeps in. Slowly you drift off, dreaming of warmth, of tropical ocean wavelets breaking across your chest, of warm sand beneath you.

Hours later, still logy and numb, you surface, as if from deep under water. A warm tide seems to be flooding your midsection. Focusing your eyes down there with difficulty, you see tubes running into you, their heat mingling with your abdomen’s depthless cold like a churned-up river. You follow the tubes to the bag that hangs suspended beneath the electric light.

Someone speaks. Your eyes move from bright lights to shadowy forms in the dim outer reaches of the room. You recognize the voice of one of the friends you set out to visit, so long ago now. She’s smiling down at you crookedly.

“It’s cold out there,” she says. “Isn’t it?”

Culled from: Last Breath: Cautionary Tales from the Limits of Human Endurance

 

Everything Was Dangerous in the 1930s!

Anna sent me this delightful article displaying 1930’s illustrations warning of the dangers of electricity.  Be careful out there – everything can kill you, even the cow!


A Helpful 1930’s Guide On How To Avoid Electrocuting Yourself

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