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Cold Seen as Key After Toddler Survives After Heart Stops for 30 Minutes

Frigid waters were a big factor in the survival of a Pennsylvania toddler whose heart stopped for nearly half an hour while submerged in a creek.
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Little Gardell Martin, the toddler whose heart had stopped for nearly half an hour while he was submerged in an icy Pennsylvania creek, is back home running around and playing as if nothing happened. His mom is sure that God had a hand in the boy’s recovery.

His doctor agrees the survival story is nothing short of extraordinary.

"I’m not going to deny that it feels like a miracle," said Dr. Frank Maffei, director of pediatric critical care at the Geisinger Medical Center. "I feel like there was an angel watching over the kid."

Maffei is quick to also credit all the medical personnel who helped save the little boy’s life, from the 30 some odd doctors and nurses at Geisinger to all of those who got in line to perform 101 minutes of CPR.

But one of the biggest factors in the boy’s survival story, Maffei and other experts said, was the frigid waters into which Martin fell. The boy’s body temperature dropped by more than 20 degrees and that is what protected his brain and other organs from being damaged by oxygen deprivation while he was under water and as he was being warmed back up.

"This is a tremendous story ... It was a very heroic effort by the team doing CPR. It deserves admiration. We like to see stories like this."

Martin was outside with two of his brothers on March 11 playing on the family’s 5-acre farm when he disappeared, apparently swept away by the fast moving waters of a creek swollen with winter snow melt. When his mother couldn’t find the 22-month-old near their home, she frantically dialed 911.

A neighbor found the boy, lifeless, caught in a tree branch with water rushing around and over him. The ambulance crew that arrived shortly after that started CPR and rushed Martin to the local community hospital. CPR continued at that hospital, and on the medical helicopter taking him to a bigger and better equipped medical center and then in the emergency room of Geisinger.

In the ER, there was a line of five people at the boy’s side, each taking a 2-3 minute turn at CPR so no one would become overly tired and the resuscitation would go on uninterrupted, Maffei said.

Meanwhile Maffei and his team started to carefully bring the boy’s body temperature up: a breathing tube bringing warmed, humidified oxygen into his lungs, tubes bringing warmed saline solution into his stomach, his bladder and his bloodstream.

The boy’s temperature was 77 degrees when he arrived. Eventually it rose to 90 and doctors decided to keep it there to aid in the boy’s recovery. The next step would be to attach Martin to a heart and lung machine. But first the doctors wanted to check one last time to see if the boy’s heart had started to beat on its own.

The only way to do that was to briefly stop the CPR that was keeping him alive.

Maffei checked the boy’s wrist for a pulse, while Dr. Richard Lambert, the attending physician in the pediatric intensive care unit, checked for a regular throbbing in the boy’s femoral artery. Maffei thought he felt something, but it was faint. Lambert confirmed he felt the same thing.

"I’m not going to deny that it feels like a miracle"

Amazingly, the boy’s heart had started beating on its own. During the wee hours of the morning one of the nurses noticed Martin had opened his eyes. To check to see if he was really awake she asked, "Gardell, do you want us to go get mommy?"

What happened next was extraordinary, Maffei said.

"He nodded his head," the doctor said. "At that point we knew he was not only a survivor but would also be neurologically intact."

Within days the boy was back home with his family. And as an update, his mom emailed Maffei a video. It showed Martin running around and playing with a big balloon.

Though Martin isn’t the first case of a child — or even an adult — to be saved by hypothermia, his may be one of the more remarkable ones based on the length of time medical personnel performed CPR, said Dr. Jon Rittenberger, an associate professor of emergency medicine at the University of Pittsburgh Medical Center. It’s also a good example of the blurring of "the previously black and white line between life and death," Rittenberger said.

"So long as they are cold, they can often be returned to full life and health."

What doctors have found is that people can survive quite a while without a heartbeat if they are cooled down 20 or so degrees, said Dr. Benjamin Abella, research director at the Center for Resuscitation Science at the University of Pennsylvania.

"There are a number of times when people have been clinically dead, sometimes for hours," he said. "So long as they are cold, they can often be returned to full life and health."

Cold puts people in a state that is almost like suspended animation, Rittenberger explained.

What’s the longest time a person has been without a heartbeat?

Abella suspects the record goes to a European woman "who was buried in an icy ravine on the ski slopes for two hours. She made a full recovery and is now a practicing physician. She was pulseless for at least an hour."

Still, Abella finds Gardell Martin’s story to be "amazing."

"This is a tremendous story," Abella said. "It was a very heroic effort by the team doing CPR. It deserves admiration. We like to see stories like this."