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Italian boy survives being trapped underwater for 42 minutes (independent.co.uk)
182 points by ValG on May 30, 2015 | hide | past | web | favorite | 76 comments

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

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

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

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?

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.

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 ?

Ha, just yesterday I went in the pool with my 3 year old. I was freezing and cursing (not in front of him of course) and he was as happy and active as on any summer pool day (I'm in the southern hemisphere).

If they were locals they were probably just used to it.

Single data point: I used to have very cold feet when walking in the snow and in the rain as a child enrolled in scouts (8-12 year-old) and it went away when I entered my teens (I think). Today I do not suffer from cold extremities and I am more likely to go for a walk outside when it's raining or snowing because why not.

Maybe I had bad shoes though.

Wim Hof who holds the world record for immersing himself in ice water says he uses his mind. He has been involved in some interesting experiments.


You get used to it really quickly, in my experience. Swimming in cold sea/lakes on holiday (in Greece of all places) the fifth/tenth or so time was way more bearable than the first.

Anyone can do this, because it isn't socially acceptable to play as an adult, the only people you would encounter already in the water would be children.

He's talking about her body temp, not the water temp. 13 c isn't _that_ cold a water temp for swimming. Plenty of people swim in 3 c water in the winter on Hampstead heath ...

13 c is however an insane body temperature.

That was her body temperature, not the water's temperature.

Indeed. The water would be even colder.

After 80 minutes, though, how much difference is there? Still some, I'm sure, but water is really good at conducting heat.

Ah right. I thought she was boiled in water

I don't get why his comment was downvoted.

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

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

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

I think it's that the same mechanisms that heal pneumonia heal lungs full of clean, cold water.

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!

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.

(Italian too here)

Actually alcohol IS a social problem, but in a way smaller size than in countries who had Prohibition. Young americans, australians and brits usually once in Italian land set their desire to drink free, causing a lot of problems (personal multiple experiences).

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.

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

I think that's probably true for most of Europe.

Italian here, and yes Italy is way more relaxed about drinking than the USA. I can't speak for the whole country, but where I'm from underage drinking is not really considered a big deal. Frowned upon yes, but that's about it.

We don't have a drinking age in Italy. If we do, I've never seen it enforced in my life. :)

Another case of useless law creating more problems than they solve.

A mojito!? How dare that kid. Next thing we know, teenagers who return to life after death will be asking for a line of coke and a couple strippers. What is wrong with the world??

His dad is Berlusconi's doctor. He'd probably already been offered those.

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?

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."

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...

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.

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.

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?

The medical term is "reperfusion injury".


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-...

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.

Ahh, Suspended Animation.

I suspect the boy was saved by the mammalian diving reflex. It is what allows whales to hold their breath for so long. It exists in a much weaker form in humans especially young ones. It kicks in when the face is submerged in cold water. 40 minutes is certainly at the high end but this isnt unprecedented



It's fairly well known that submersion in cold water can lead to recoveries after periods of time far longer than would be expected in other circumstances.

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...

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.

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

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

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

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

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 [2] https://en.wikipedia.org/wiki/Pediatric_advanced_life_suppor...

Context: I spent my civil service (+2 more years as a volunteer) serving as a paramedic for the italian national healthcare in Milan.

Paramedics/EMTs can't declare anyone deceased (they are not doctors) and on ambulances there are no doctors. This means that, as paramedics are first to arrive on the scene, they HAVE to perform CPR and defibrillation over anyone until a doctor declares death (only exception is with conditions that are "incompatible to life", example: decapitation). Two more details: no doctor would declare a boy dead on the place - they would AT LEAST require the ambulance to bring the person to the closest hospital, which implies that CPR and Defibrillation is performed for several minutes anyway (usually, ~10-30mins to reach the closest hospital). Last detail, doctors are anyway required by law to ensure that at least 45 mins of CPR has been performed before being able to declare anyone formally dead.

All this procedure may seem overkill but I can assure you that I personally experienced at least two cases where I thought the person didn't stand a chance but then actually fully recovered.

So, the whole story makes perfectly sense :)

Perhaps things are different in Italy, but here in the US I can absolutely pronounce someone dead. 'EMT' is a lower level of training, and do require the 'injuries incompatible with life' criteria, but as a paramedic, I have far more leeway. patient has an unknown downtime, is cool centrally, has visible lividity, or early stages of rigor, then I'm just going to hook up an EKG to confirm asystole, call my dispatcher for an official timestamp, and hand the scene over to the police.

It said they took 15 days reviving him.

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.

I take it the image is of the doctor.

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

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.

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

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

"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".

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


Assuming your question is not rhetorical, do you mean 'why is this on the front page of Hacker News', or 'why is this on Hacker News?'

If your question is the former, and thus regarding rank, then there are a few resources from where you could begin pursuing an answer to your inquiry [0].

If your question is the latter, Hacker News has clear guidelines [1]. When I find something is not immediately of interest to me, I like to pause thinking about myself for a moment and ask myself, 'would this be of interest to others in the community?'

Further, based on the recency of the post and upvotes, the answer to that question is 'yes, there are some numbers of 'hackers' or Hacker News readers who find this article interesting.'

[0] http://www.righto.com/2013/11/how-hacker-news-ranking-really... [1] https://news.ycombinator.com/newsguidelines.html

Because flashes of insight and great ideas often come from reading articles about topics outside of our individual fields. Also, hacker news is primarily for entrepreneurs and hackers (not in the criminal sense of the word) which means besides the small common threads like technology and business, we come from all walks of life and fields.

Just for interest: why shouldn't be on the front page? Why do you think this is off topic?

And what should? What do you think is on-topic?

Perhaps he or she doesn't know about cryonics and that people are seriously working towards it: http://en.wikipedia.org/wiki/Cryonics

I'm surprised you're surprised. A lot of people associate HN with software and startups. They don't realise its scope is a bit broader.

Nothing in my comment indicates surprise.

well, all i can say is

praise the lord for that


no love for the Justice League loser?

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.

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.

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

fair enough, that's been my experience

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