Hypothermia May Save Boy Trapped in Ice

Jan. 8, 2010— -- While snowboarding in a remote canyon on Oregon's Mount Hood, Marcia Page lost her bearings and soared over a 65-foot cliff, bouncing on her head off rocky outcroppings before crashing in the snow below.

The right side of Page's head caved in and all four walls of her eye socket were fractured, as well as multiple bones throughout her body. As the neonatal nurse, 43, was airlifted out with her brain hemorrhaging, she stopped breathing.

What saved her life was the 45 minutes her body lay in the snow in the cold air at 6,000 feet, as hypothermia sent her body temperature down to 90 degrees.

Page's survival gives hope to the family of Thomas Hudson, the 6-year-old British boy who is fighting for his life after falling into a frozen pond this week. Trapped under the ice, the boy's heart and breathing stopped for 30 minutes before he was resuscitated.

"What kills you is lack of oxygen to the brain," said Dr. Martin Schreiber, a U.S. trauma surgeon who worked on the team to save Page's life in 2001 at the Oregon Health & Science University in Portland.

"When they retrieve people under ice for a long time, even if they have no signs of life, the dictum is, 'not dead until warm dead," he told ABCNews.com. "That's how we are trained."

At normal body temperature -- 98.6 degrees –- the brain can only survive without oxygen for about five to 10 minutes, Schreiber said. But when hypothermia sets in and the body temperature cools below 95 degrees, metabolism slows and so does its need for oxygen.

As snow pummeled England this week, little Thomas wandered onto a backyard pond in the village of Crookham Common, Berkshire, and became trapped under the ice. His mother, alerted by a playmate, tried to pull him from the center of the 60-foot pond.

When firefighters finally freed the boy, paramedic Hugh Whitaker told the Sun newspaper that the boy was blue and "in a bad way." He was airlifted to John Radcliffe Hospital in Oxford..

Thomas underwent an undisclosed precedure and is in critical condition, hospital spokeswoman Laura Carpenter told ABCNews.com.

His family, who have been at the boy's beside for three days, have refused interviews and asked for privacy.

The boy's doctors are hoping the icy waters may have shut down his heart and brain long enough for him to survive.

"The case is interesting," said Dr. Benajmin Abella, director of clinical research in the Center for Resuscitation Science at the University of Pennsylvania. "There have been cases reported with no breathing or blood flow for an hour."

Boy Trapped in Ice Likely Had Bypass Operation

Abella, an emergency physician who specializes in the treatment of cardiac arrest, said Thomas' treatment was likely a cardiopulmonary bypass procedure to gently re-warm his blood and organs. The bypass machine controls blood flow, giving the heart a rest.

"It's a very exciting new area of medicine by using cooling as a therapy," he said. "We have a real chance at saving people who have been previously left for dead."

Such was the case in 2004 with a Wisconsin man who was brought back from the dead on a cardiopulmonary bypass machine after he survived a cold night unconscious in a snow bank.

Like Thomas, David Samuels, 63, had no pulse for more than 30 minutes and his body temperature had dropped to 75 degrees.

When he was found the next day, Samuels was cold, blue and near dead. But doctors used a bypass and, in 90 minutes, his temperature returned to 98.6 degrees without injury.

"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."

Survival Worse Than Accident

"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.

Snowboarder With Brain Injuries Walks Again

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.

"It was harder on my family than anybody," said Page, who now lives in Cove, Ore. "They were told they didn't know if I would wake up and if I'd have the same personality or abilities I had before."

Her 26-year-old daughter was so moved that she decided to get a medical degree.

Today, at 52, Page is back on Mount Hood, hiking and snowboarding, this time with a helmet. She even coached her son's high school snowboard team, taking them to the state championships.

"Snowboarding feels like being rocked in the cradle; weightless, transcending another world, like floating free," she said of the sport that nearly took her life.

"That's why I got back up there, what drove me. I wanted to feel that feeling again."

Her husband, Dr. John Page, a medical flight surgeon with the Air Force Reserve and private physician, is astounded by his wife's recovery.

"Never in my 25-plus years in emergency room medicine have I seen someone come that close to surviving with the injuries that she had," he told ABCNews.com.

"Now she is pretty much back to normal," he said. "I see other brain trauma injuries and these people do poorly. The whole hypothermia thing played a role."

Marcia Page said that after waking up from her coma, she learned "one of the most important lessons of my life."

"I grew up believing my human worth was based on how productive and useful I could be," she said. "But lying there in my hospital bed, I wasn't able to do a single thing for myself, much less for anyone else.

"It was then, at age 43, as endless care and attention were poured into me while I just laid there damaged and useless, that my value is based on one fact alone: My heart beat."

ABC's Information Specialist Brad Martin contributed to this report.