Desperate times call for desperate measures, but those measures aren’t always effective. In the case of 20-month-old Waylon Saunders, however, the tireless efforts of an entire hospital brought him back from beyond the brink of death. Prolonged CPR was used to save the toddler, whose heart was stopped for at least three hours. His case is bringing new awareness to the power of CPR and to the surprising effects of cold temperatures on the human body.
 
Waylon’s ordeal began when he was found face down in an in-home daycare’s icy cold swimming pool, where he had presumably been for at least five minutes. By the time paramedics arrived, his body temperature was so low that they couldn’t get a reading, and his heart had stopped beating. He was rushed to Charlotte Eleanor Englehart Hospital in Petrolia, Ontario, which lacked the advanced equipment found at larger hospitals and wasn’t prepared for this kind of emergency. Technically, little Waylon was already dead. Yet, for the next three hours, everyone from nurses to lab technicians lined up to give the toddler CPR as others tried to raise his body temperature. The idea was that if they could keep his blood flowing to his heart and brain as he was warming up, he might be resuscitated—and they were right. Waylon Saunders is alive today and seemingly none the worse for the wear.
 
Strangely enough, not only is there a precedent for cases like Waylon’s, there is a medical procedure based on the same principles that saved him called therapeutic hypothermia. When a patient suffers from cardiac arrest and their heart stops beating, that leads to oxygen deprivation, which in turn leads to brain damage. But for reasons that are not yet well understood, hypothermia can slow or halt the damage. With therapeutic hypothermia, a patient has their body temperature reduced to between 89°F and 93°F (32°C and 34°C) for around 24 hours. During this time, it is thought that the cold temperatures slow down the chemical reactions in the patient’s body and reduce inflammation in the brain, keeping them healthy. It could be that in Waylon’s case, along with the hospital staff’s unwavering efforts to resuscitate him, the frigid conditions of the water he was found in actually helped save his life. It really gives new meaning to the term “cold-hearted.”

 
[Image description: A close-up photo of someone performing CPR on a medical dummy.] Credit & copyright: manseok_Kim, Pixabay

Looking for more reasons to move to Seattle? Sudden cardiac arrest has long been a leading cause of death among adults. Despite continuous research for more effective solutions, CPR--which stands for cardiopulmonary resuscitation--is still the gold standard. (It's also still performed to a 1970's song, as we learned in a recent Curio.) In the US alone, there are 350,000 annual resuscitation attempts outside hospitals, and 750,000 attempts in hospitals. The survival rate in hospital is 20%, versus around 5% outside. What's more, cardiac arrest survival rates depend greatly on your location. Chances of surviving in Seattle are 20%, versus only 3% in Detroit. This is a much bigger variation than seen with strokes and heart attacks. Experts believe this is because of medical technology and process advances happening in a few cities such as Seattle. It starts with better training of EMS providers, and public awareness that bystanders should jump in immediately to attempt CPR. Secondly, most good samaritans, EMS providers, and doctors tend to go too slowly, pause too long to check for a pulse, and stop administering CPR too soon. Experts now recommend administering between 100 and 120 compressions per minute, at a depth of five centimeters, for 45 minutes! That's a serious workout, and requires not only training but multiple people. Then, once the patient is in the hospital, more advanced techniques are required to save the lives of people who have had CPR properly administered. One procedure is called extracorporeal membrane oxygenation (ECMO), where blood is drawn from the patient, circulated through an oxygenated filter, and then returned to the body. Another technique is therapeutic hypothermia, where the patient's body temperature is lowered by up to 10°F for 24 hours to slow the death of cells. If these innovations were universally implemented, as many as 30,000 lives could be saved annually in just the US. So don't wait any longer, take a Curious lesson today on how to administer CPR.

Defibrillators for all! The US government recently passed the HEARTS Act, a bill that, once signed into law, will fund the installation of emergency defibrillators (also called AEDs, or Automated external defibrillators) in U.S. schools. The law will also provide training on how to use them and how to perform CPR. NFL player Damar Hamlin, who suffered cardiac arrest during a game in 2023 but was saved via CPR and an AED, has been publicly championing the bill for months. In a recent statement, Hamlin pointed out that cardiac arrest usually happens unexpectedly, making emergency preparedness all the more important. “My journey has shown us that no one expects cardiac arrest to happen and we all need to be prepared,” he said.
 
Contrary to popular belief (and some dramatized depictions in popular culture) defibrillators don’t “revive” people who have already passed away. Rather, they restore a normal heart rhythm to people who have developed a dangerous, abnormal heart rhythm (called arhythmia) wherein the heart beats too slow, too fast, or erratically. Defibrillators can also help in cases of cardiac arrest—when a person’s heart suddenly stops beating. Cardiac arrest doesn’t mean that a person has died (that doesn’t happen until brain death occurs) but it quickly becomes fatal if a normal heart rhythm isn’t restored. Defibrillators are one of the few medical tools that can do this quickly, by attaching to a person’s chest, reading their irregular heartbeat (or lack of a heartbeat) and administering an appropriate electric shock to restore a normal rhythm. Of course, defibrillators can only do their job if they’re used properly, which is where the HEARTS Act and its defibrillator training comes in. Many Emergency defibrillators also use voice prompts once they’re activated, giving step-by-step instructions to whoever is attempting to use one. Pair that with basic training, and students in U.S. schools could soon be potential life savers.

 
[Image description: A yellow stethoscope wrapped around a red, paper, cartoon-style heart.] Credit & copyright: Kaboompics.com, Pexels

It was a heart-stopping moment, and not in a good way. Buffalo Bills safety Damar Hamlin is on the road to recovery after collapsing at a recent game under extremely rare circumstances. On January 2, Hamlin’s heart stopped shortly after being on the receiving end of a routine tackle. If it hadn’t been for the tireless efforts of on-site medical staff, Hamlin may not have survived. While no official statement has been made by the team regarding Hamlin’s diagnosis, many are pointing to commotio cordis as the likely cause. Commotio cordis (Latin for “agitation of the heart”) occurs when the left side of a person’s chest is subjected to a powerful impact. It also requires direly unfortunate timing. When the impact hits the chest right after the heart contracts, it can cause the chambers to contract again when they’re supposed to be at rest. This leads to ventricular fibrillation, or an irregular heart rhythm, and cardiac arrest. Because it requires such precise timing, commotio cordis is incredibly rare with only around 30 cases a year in the U.S., but any impact on the chest at a 90 degree angle with sufficient force can cause it. In the past, impacts from baseballs, lacrosse balls, and even hockey pucks have led to the condition. The condition has about a 59 percent survival rate if CPR is given promptly, and those who are successfully treated can even return to playing sports. So, while Hamlin hasn’t made any definitive statements regarding his future with the Bills, it’s not out of the question that he will be capable of playing again. Here’s hoping this safety has a speedy recovery.

[Image description: Two footballs sit in a grassy field.] Credit & copyright: matthiaskost, Pixabay