Hypothermia Likely Saved Avalanche Victim from Brain Damage - @ JEMS.com

Hypothermia Likely Saved Avalanche Victim from Brain Damage


Pat Reavy | | Friday, December 28, 2007

Park City, Utah -- The story of 11-year-old Max Zilvitis' recovery after being buried in an avalanche for 33 minutes is nothing short of a Christmas miracle.

When rescuers found Max he had no pulse and was not breathing. Through heroic life-saving efforts of The Canyons Ski Patrol, the medical helicopter crew that took him to Primary Children's Medical Center and doctors at the hospital, Max was listed in good condition Wednesday and out of intensive care.

His parents released a statement Wednesday saying Max was "recovering steadily" and "doing incredibly well." His parents were also "forever grateful" to everyone who helped save their son's life.

The Park City resident and his father were skiing at The Canyons on Sunday when a slide buried Max and partially buried Brian Zilvitis. Brian was able to quickly free himself. But Max was completely buried in the avalanche that was up to 5 feet deep in spots, according to the Utah Avalanche Center.

The first call of the incident was received by The Canyons dispatch at 11:17 a.m. When the ski patrol got to the area they set up a probe line using volunteers on the scene. At 11:50 a.m. a 15-year-old girl participating in the probe line found Max.

CPR was started immediately after he was excavated. He was breathing on his own by the time he was taken away by medical helicopter, according to the avalanche center.

Dr. Colin Grissom is a pulmonary and critical care specialist at Intermountain Medical Center and has spoken with doctors who treated Max.

A treatment technique that essentially puts a patient into a hypothermia-like state likely saved Max from any serious brain damage.

There are many studies showing that avalanche victims who are trapped for up to 15 minutes still have a 90 percent survival rate, Grissom said. Victims trapped between 15 to 35 minutes have a 30 percent survival rate.

But as long as there is a way for the air a victim is breathing out to escape, there have been cases of people buried for more than 20 hours and surviving, Grissom said.

"Anyone who lives beyond 35 minutes (of being buried) has some kind of air pocket," he said.

The leading cause of avalanche-related deaths is suffocation, Grissom said. But there is actually air in the snowpack, he said. If expired air can escape so a person buried by an avalanche is not rebreathing what they exhale, then the chances of survival increase.

When rescuers reached Max, "he was close to the limits of what he could survive" according to statistics, Grissom said. "He was blue and not breathing."

Once rescuers got him breathing again, the next concern for paramedics and doctors was to make sure he recovered with as little brain damage as possible.

"The chance of having brain damage due to lack of oxygen are high," he said. "If you cool them to 32 to 34 degrees Centigrade, there's a better chance of a good neurological outcome."

Grissom and other doctors have used the hypothermia-like treatment on other patients, such as those who suffer cardiac arrest, to reduce the possibility of permanent brain damage. In Max's situation, doctors had to actually warm his body up to 32 degrees Centigrade, he said.

But once his brain was between that 32 to 34 degree level, doctors kept Max at that temperature for 24 hours to allow his brain time to recover, Grissom said. Normal body temperature is 37 degrees Centigrade.

Although Max's progress was still being monitored by doctors, as of Wednesday there did not appear to be any sign of serious brain damage.

Grissom said a lot of credit should go to everyone, from the ski patrol to the doctors at the hospital and everyone who treated Max in between, for helping his recovery go as well as it has.

E-mail: preavy@desnews.com

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Related Topics: Industry News, Cardiac and Circulation, Airway and Respiratory, Medical Emergencies, Operations and Protcols, Special Patients

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