"Like this young boy, we keep them cool during the resuscitation phase and in the immediate care afterward," Abella said. "Generally, when tissues in the body have no blood flow or oxygen, they are hypersensitive to the return, like putting gas on a fire, and it sets off inflammation. It's not well-understood. CPR alone could kill them."
It could take up to a week to know Thomas' prognosis but Abella is optimistic.
"If I were talking to the family, I would say it's going to be a marathon, not a sprint and it may be a week or two before the dust settles and it's clear how he will do," he said. "But there is a good chance he can make a full recovery."
"In younger, healthy patients, it's remarkable how the body is designed to live," he said. "I can't say for certain whether he will make it or not and, clearly, he will have a complicated road ahead."
Such was the case with snowboarder Page. "The worst part of the accident hadn't been falling over the cliff, but surviving it," she said of the cognitive disabilities and depression she suffered in the aftermath of her recovery.
As she lay on the mountain in the aftermath of the crash, the mother of three had one last flash of consciousness: "Oh, no, this is where I am going to die. My poor husband and kids, how long will it take to find me and how horrible it is for them?
"I couldn't even cry out," said Page, who blacked out and remembers nothing until she woke up in the hospital a month later.
In a perfect storm of good events, a trauma nurse was skiing in the same area and used a satellite phone to call a medical helicopter.
"She found me, recognized the severity of the head trauma and actually flagged down another snowboarder with a satellite phone," Page said. "A cell wouldn't work in that area."
The helicopter had turned back from a call on the Oregon coast as the fog was rolling in. "He had just fueled up and came directly to Clark Canyon," she said. "It was unprecedented. He had just got landing coordinates that week."
The flight nurse helped talk the pilot down. She was familiar with the terrain because her husband had recently been injured in the same place.
"He had to hover over the glaring ice and the flight nurse and paramedics jumped out and intubated me on the snow," she said.
In all, the rescue took 45 minutes before Page was rushed to Oregon Health & Science University. A CT scan showed her brain was herniating and had oxygen deprivation.
"It was devastating," said surgeon Schreiber, who tells her story at medical conferences. "We were all certain that she was going to die and we had essentially no hope for a meaningful recovery. "
Page was kept alive on a ventilator and underwent bone-flap surgery. Dr. Randy Chestnut, the doctor who had pioneered the procedure, removed the right side of her skull and a half-dollar sized piece of her temporal lobe to relieve cranial pressure.
Kept in a medical coma for 14 days, she was hospitalized for two months. Her skull was reassembled with numerous little screws and she learned to walk again in rehab.
"To this day, I know I have deficits," said Page, who still struggles with double-vision and takes medication for seizures.
Although she had to give up the demands of acute care nursing, she is able to work as a summer camp.