

Italian boy survives being trapped underwater for 42 minutes - ValG
http://www.independent.co.uk/news/world/europe/italian-boy-survives-being-trapped-underwater-for-42-minutes-10280563.html

======
jwise0
There's a reason why they say that "you're not dead until you're warm and
dead"!

The case of Anna Bågenholm [1] is similarly fascinating. She was in cold
meltwater for 80 minutes before being pulled out, and made a ~full recovery.
Her core temperature was around 56 degrees when they began resuscitation. It
is truly amazing how effective hypothermia is at preserving bodily function!

[1]
[http://en.wikipedia.org/wiki/Anna_Bågenholm](http://en.wikipedia.org/wiki/Anna_Bågenholm)

~~~
jnardiello
For the convenience of non-US commenters/readers: that's 13 C.

~~~
unicornporn
And for those who don't regularly swim in open water, that's f __ __*g cold.

~~~
Shivetya
having been in the water below a dam its amazing just how cold it can be. The
best part is, watching a friend drop an expensive knife in less than four feet
of water and unable to retrieve it cause of the cold. Fortunately a few young
kids came wading down the same river in this water and when they asked my
friend what was wrong he pointed to the knife and the one kid simply went
under and got it.

and to my point, perhaps younger people have better ability to not suffer the
ill effects of such temperatures? I am sure many can remember being in snow or
sweltering hot weather where adults all went indoors or such. Is it ignorance
or something physical?

~~~
SoftwareMaven
Having watched my kids grow up while observing this effect, I've come to the
conclusion that kids' nervous systems aren't as sensitive as adults. That, or
they are just brain damaged. :)

Ignorance is an interesting question. Does it not bother them because they
haven't been conditioned that it bothers them? It makes me think of pain. The
anxiety of anticipating pain and of what experiencing the pain will be like is
often as or more significant than the pain itself and can cause significant
impact on the sufferer's life _irrespective of the pain itself_. Dogs, on the
other hand, do not anticipate the pain, so, even when they hurt, it doesn't
have the same impact on their lives.

That's a long way around to get to this: maybe it's not the discomfort of the
cold itself that is highly uncomfortable, but the anxiety of the
_anticipation_ of what the cold will be like, and that is not something kids
have the experience to, well, experience.

~~~
agumonkey
I thought about this about falling. Kids do fall all the time, but instead of
anticipating failure, they go all in for "success" (whatever success can be
for a kid). More momentum is created, diffusing energy in a smoother way. The
mindset shutting down the brain for the "negative" aspects of the situation,
because it came from a desire not from fear.

I have similar thoughts when playing music, whenever I get a nice sound, I
don't feel pain or exhaustion, but every time I fail it suddenly become
tiresome.

The brain as an amplifier ?

------
torsday
Some interesting drowning facts:

\- Clean and cold water is ideal: pneumonia and metabolism.

\- If you revive a drowned person, insist they go to the hospital: CPR can
push the fluid in their lungs into their blood, only to return later on,
drowning them all the same, "parking lot drowning."

\- Quite often, water doesn't enter their lungs as their vocal cords spasm.

~ Paramedic in another life

~~~
kazinator
You mean clean, cold water is ideal for avoiding the bacterial infection (e.g.
streptococcus pneumoniae) that causes pneumonia?

~~~
JshWright
Clean to avoid pneumonia. Cold to avoid brain death (or to delay it, at
least...)

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pinky1417
Did anyone else catch the doctor mentioning that the boy recently asked for a
mojito?

It's a bit surprising that a 14 year old would ask for alcohol in a country
where the drinking age is 18. But hey, it's Italy, perhaps there significantly
more relaxed about kids drinking than Americans like me!

~~~
jnardiello
Yes, the relationship of italians with alcohol is significantly different than
the one in english-speaking countries. Much more "sane" and relaxed, I'd dare
to say.

Alcohol isn't a social problem and it's tolerated for young people to drink
(or to smoke weed) despite not being yet 18 - at least in Milan.

~~~
mariuolo
I wonder, though, if it was alcohol that prompted him to jump in the water in
the first place.

He wouldn't be the first drunk who decided to do something stupid. I recall a
British tourist who died in Venice after thinking it was a good idea to take a
swim in the lagoon a few years back.

~~~
octatoan
A few days back, a small-time sitcom actor here jumped into a pond drunk and
drowned.

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louwrentius
It seems that the cold water also contributed to his survival. He only had to
lose a lower leg, no brain damage.

This is always the question: very nice you are able to survive x y or z, but
in what condition do you get out of it: like a vegetable or like a human
being?

~~~
hliyan
Wasn't this also a factor:

"The team also used a technique called extracorporeal membrane oxygenation
(ECMO) to extract oxygen-deprived blood, warm it up and add oxygen, before
pumping it back into the body, The Times reported.

After 10 days of using the technique, which mimics the function of the heart,
while Michael was in an induced coma, he survived."

~~~
JshWright
Sure, but it's the fact that he was rapidly cooled in the first place that
made ECMO an option at all.

You can't just take someone who has been dead for 40 minutes and slap 'em on
an ECMO machine...

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azinman2
Unbelievable. Typically an oxygen starved brain can be permanently destroyed
in minutes, like alone more than half an hour. Just shows that what we think
are limits to human capacity are more just experienced we've had until now.
Very inspiring.

~~~
zamalek
Brain death actually occurs at the time of resuscitation. As it wakes
individual cells kill themselves as a result of a kind of "self check." If you
cool the brain before resuscitation you can hopefully delay the self check to
the point where the cells are correctly oxygenated and healthy when it
happens.

Dying somewhere cold cools your brain, giving you a better chance when you are
resuscitated.

~~~
garblegarble
That's fascinating, could you point me somewhere I can read more? I'd always
assumed something in the cells was decaying without oxygen preventing them
from functioning again. Is it some sort of reaction byproduct that normally is
part of a chain but the lack of oxygen breaks the chain and makes some other
reaction occur?

~~~
waffl
This reminds me of a medical technique that was going into trials I read about
on HN last year, I can't find the conversation link but this article in the
nytimes is speaking to the same topic:
[http://www.nytimes.com/2014/06/10/health/a-chilling-
medical-...](http://www.nytimes.com/2014/06/10/health/a-chilling-medical-
trial.html?_r=0)

~~~
zamalek
It was used quite successfully recently (which is how I learnt about it), but
I can't for the life of me find the link. A technically brain dead patient was
bought back to life with little brain damage.

------
legohead
I wonder why they even tried CPR or a defibrillator. They spent 42 minutes
rescuing someone who was underwater, and then decided to try and revive him?
Maybe there are details left out, like he was not fully submerged the entire
time...

~~~
JshWright
It's a kid... you try.

Worked a 3 year old a couple weeks ago with an unknown downtime in a pool (up
to 15 minutes). He was dead from the outset (initial rhythm was asystole), and
he stayed dead (much warmer water in this case), but you still try...

This is especially true for cold-water drownings. Downtimes even longer than
42 minutes with full recoveries are not unheard of. You're not dead until
you're warm and dead.

~~~
sukilot
I'd hope you'd try for an adult too.

But anyway, thank you for your life-saving service.

~~~
JshWright
The window for 'trying' is longer for kids (that's based on more than just
emotion though... kids are a lot more resilient).

~~~
jnardiello
Don't you have protocols for this? Is it entirely up to individual preparation
for how long (and how) you 'try'?

~~~
JshWright
It's a bit of both... I have an 'obvious death' protocol that can apply if
someone is, well... obviously dead. If they are not obviously dead, and do not
have a DNR (or a 'MOLST' in New York) then we'll begin resuscitative efforts
(using either ACLS[1] or PALS[2] guidelines, as appropriate). If the patient's
heart has any sort of electrical activity going on, we'll generally spend
15-20 minutes trying to get it working properly again before calling a medical
control physician to get permission to stop efforts and pronounce death.

If there is no electrical activity, then we'll go through a couple 'rounds' of
ACLS, and it there is no response, we'll just pronounce them. Very rarely do
we transport an adult in cardiac arrest. CPR in a moving ambulance is very
difficult to perform adequately, and in most cases we would just be bringing
them to a facility that would be providing the same level of care that we are
in the field (albeit with more hands available to help, but the tradeoff in
time and poor quality CPR isn't worth it).

The only exception to this are cases of traumatic arrests. If something is
physically broken, no amount of CPR, drugs, or electricity are going to help,
and their only hope is bright lights and cold steel (in a surgeon's hand).
Needless to say, the survival rates for out of hospital traumatic arrests are
_vanishingly_ small.

Kids are different though... They're easier to move, and easier to do CPR on.
This means in most cases a pediatric arrest is a 'scoop and run', with any
interventions being performed on the way in. This is in part because the
resiliency of kids means they are a _little_ more tolerant of the time, and
scene's with dead kids tend to be extremely chaotic. It can be very difficult
to concentrate with an (understandably) distraught parent yelling at you.

[1]
[https://en.wikipedia.org/wiki/Advanced_cardiac_life_support](https://en.wikipedia.org/wiki/Advanced_cardiac_life_support)
[2]
[https://en.wikipedia.org/wiki/Pediatric_advanced_life_suppor...](https://en.wikipedia.org/wiki/Pediatric_advanced_life_support)

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tedunangst
Why is there a picture of some random dude with the caption "the teenager
jumped off a bridge in Milan"? I'm assuming he didn't also age 30 years in the
process.

~~~
qubex
I take it the image is of the doctor.

~~~
Elrac
What I found most disturbing is that this doctor looks like Deepak Chopra.

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jmkni
Off topic, but I find it amusing that the title says, "Italian boy...", the
image caption says, "The teenager..." and then the photo is of a middle aged
man.

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tombozi
So if I understand this correctly, we will soon be able to put people into
'hibernation mode' by first cooling down their body temperature?

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nicolewhite
At one point the article claims he fell into the canal, then a couple
sentences later says he jumped in willingly. Which is it?

~~~
manarth
"An Italian boy who fell into a canal…" "The 14-year-old, who is said to have
jumped off a bridge in Cuggiono…"

It sounds very much like 'journalist-speak'. When they start with "He fell
into a canal", they're establishing the boy's innocence - i.e. he wasn't
trying to kill himself, wasn't up to anything dodgy, etc. They're also
establishing plausible deniability in the event of a libel suit. When they add
'who is said to have jumped off a bridge", they're probably adding conjecture
from bystanders, but holding back from saying this as fact, perhaps because of
the risk of a libel lawsuit (maybe it's a criminal act due to a byelaw
forbidding jumping from that bridge), perhaps because they haven't had enough
confirmation to say confidently that he chose to jump - they just know he
ended up in the water. So they end up beginning with "He fell into the canal",
followed by the reports they've had from one or more witnesses "He is said to
have jumped".

~~~
sukilot
That's a long way of saying they were being careful with language to avoid
making incorrect statements.

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finalight
well, all i can say is

praise the lord for that

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chimmychonga
AQUAMAN!

~~~
kleer001
no love for the Justice League loser?

~~~
rictic
Simple jokes are almost always voted down. Even when they're funny, they're
not the target tone of the site. It's not personal, it's just an editorial and
community-direction choice.

~~~
mitchi
I had noticed everyone had the same typical serious programmer personality
here. That's why I enjoy reddit a lot more because it's not like that 100% of
the time.

~~~
eueueu
don't forget these startup guys are literally saving the world one webapp at a
time. It's serious stuff.

