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Cold kills

hypothermia2

Update: This story has been updated to reflect Keith Stephens’ condition.

A Willow man is in a coma in a hospital in Alaska’s largest city after apparently slipping on snow-covered and icy ground, sliding beneath his pickup and ending up pinned there for hours in temperatures near zero or colder.

A neighbor of Keith Preston Stephens reported the 58-year-old man’s Ford F-250 had gone off the road only a minute or two from his home on Saturday. 

A family member said Monday that Stephens remains in the intensive care unit at the Providence Medical Center, but doctors believe he has a good chance of survival. He does appear, however, to have suffered severe frostbite to his hands.

Stephens was described as “a real toughie,” who could still use “lots of prayers.”

Neighbor Rudy Wittshirk said Stephens’s truck ended up off the road and stuck at a steep angle. Wittshirk theorized that in getting out Stephens “slipped on the embankment, fell under the vehicle and was rendered unconscious. I presume people drove by and simply saw a truck off the road, a common occurrence, and did not notice the driver lying underneath.”

Alaska State Troopers reported they received a report of the truck in the ditch near mile 39 of the Willow Fishhook Road just before 11 p.m. Saturday. The trooper report was unclear as to when help  actually arrived on the scene.

It said a trooper and emergency medical service personnel pulled an “unresponsive male” out from under the truck and medevaced him to Providence “with suspected life threatening injuries due to hours of exposure to sub-zero temperatures.”

Friends believe Stephens was under the truck for four or five hours, Wittshirk said. They reported his body heat had melted all the snow beneath him. It is unclear how well he was dressed.

Stephens had a core temperature of 76 degrees when he arrived at the hospital in Anchorage, about 70 miles south of the scene of the accident. Normal body temperatures is 98.6 degrees.  Most people lose consciousness when their core temperature drops to somewhere between 82 and 78 degrees. Core temperatures below that are considered seriously life threatening.

“…This is well below the temperature region where the body shuts down,” said Wittshirk, a highly experienced outdoorsman. “It is extraordinary that Keith survived at all.”

He is being helped by science that has learned a lot in the last couple decades.

Several apparently dead people have now been brought back to life with proper rewarming after suffering severe hypothermia. A revolution in treatment started after a Norwegian woman was reportedly”frozen solid” after falling in a creek while on a ski outing in 1999.

Survival story

Twenty-nine-year-old radiologist Anna Bågenholm had no detectable heartbeat when pulled out of the water, Fiona Macdonald reported in Science Alert last year. “She wasn’t breathing. She was clinically dead. No one had ever been brought back from such a low temperature before, but her friends (a pair of Norwegians doctors) immediately started CPR on her, hoping that she might be able to be revived after being air-lifted to the University Hospital of North Norway in Tromsø.

‘By the time she reached the operating room at the hospital, it had been more than 2.5 hours since she first fell in the ice, and her temperature was still an unprecedented 13.7 degrees Celsius (56.7 Fahrenheit).”

Doctors weren’t optimistic, but they began slowly rewarming the young woman.

Twenty-four hours after the accident, her heart started beating again. Eleven days later, she opened her eyes.

“But it took more than a year for her to be able to move and walk again due to nerve damage,” Macdonald wrote. “She’s now fully recovered, and works at the same hospital that saved her life.”

Bågenholm’s survival led to changes in hypothermia treatment protocols.

Prior to 1999, no patient who arrived at the Tromsø hospital with a heart stoppage form hypothermia survived, Norwegian doctors reported in a 2014 study, but after the Bågenholm case an agreement to use extracorporeal life support (ECLS) for rewarming saved nine out of 24 patients between 1999 and 2013.

The study published in Rescucitation was titled “Nobody is dead until warm and dead,” an idea first voiced by Alaska Dr. William Mills, an earlier leader in hypothermia and cold-injury research in the 1970s.

“His frostbite program in Anchorage was started with a $50,000 research grant from the U.S. Naval Research Department and later buttressed with a grant from the Alaska Legislature for $800,000 that was administered by the School of Nursing and Health Science at University of Alaska Anchorage,” his 2011 obituary noted. “From this funding, he developed the High Altitude Research Camps at 7,300 feet and 14,000 feet on Mount McKinley.

“While practicing in Alaska, Dr. Mills developed a system of care for freezing-injury that is now utilized in most of the world. He was cited as ‘the nation’s leading authority on cold injury’ at that time, and has been written of and referenced for his expertise in many journals and symposia.”

More than a few Alaska climbers can thank Mills for the fact that they still have fingers and toes that suffered through frostbite. Friends of Stephens are hoping the knowledge accumulated over the years will help him.

 

 

 

 

 

 

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