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Anna Bågenholm

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Anna Bågenholm
Born1970
Vänersborg, Sweden
NationalitySwedish
OccupationRadiologist
Known forLowest survived body temperature ever recorded in a human
PartnerTorvind Næsheim

Anna Elisabeth Johansson Bågenholm (born 1970)[1] is a Swedish radiologist from Vänersborg. In 1998, she became a surgeon assistant at the hospital in Narvik, Norway. While skiing in the mountains outside of the town on May 20, 1999, she accidentally fell into a frozen stream and got stuck under a layer of ice for eighty minutes until she was rescued. Bågenholm was able to find an air pocket under the ice, but became clinically dead after forty minutes in the water. Her body temperature decreased to 13.7 °C (56.7 °F)—the lowest survived body temperature ever recorded in a human.

Bågenholm was transported by helicopter to the Tromsø University Hospital, where a team of more than a hundred doctors and nurses worked for nine hours to save her life. Bågenholm woke up paralyzed from the neck down on 30 May 1999, and recovered in an intensive care unit for two months. Although she has made an almost full recovery from the incident, she still suffers from minor nerve damage in her hands and feet. Bågenholm is currently working as a radiologist at the hospital where her life was saved.

Background and incident

Bågenholm was skiing in the mountains outside of the town Narvik (pictured) when she fell into a frozen stream.

Anna Bågenholm was born in 1970[1] in Vänersborg, Sweden.[2] At the time of the incident, she was twenty-nine years old and studying to become an orthopedic surgeon.[3][4] Bågenholm decided to do her residency in Narvik, Norway,[5] and in May 1998, she became a surgery assistant at the Narvik Hospital.[6] Bågenholm's mentor during this period was Yngve Jones, a doctor at the Narvik Hopsital who was about to celebrate his retirement with a party in May 1999.[7]

On 20 May 1999, the day of the party,[7] Bågenholm was skiing in the mountains outside of Narvik with two of her colleagues,[8][9] Marie Falkenberg and Torvind Næsheim.[5] Bågenholm is an expert skier[5] and usually skied after work.[3] On this day, as she was heading down a steep mountainside—a route she had taken several times before[7]—she lost control of her skis. Bågenholm fell head first onto a layer of ice on a frozen stream near a waterfall and landed on her back.[8][10] A hole opened up in the ice and Bågenholm's head and torso were pulled in as meltwater filled her clothes.[8] Her body became stuck under the ice, which was 20 centimetres (7.9 in) thick.[11] When Falkenberg and Næsheim found Bågenholm, only her feet and skis were above the ice.[8]

Rescue attempts

Bågenholm's colleagues made an attempt to free her but failed.[12] At 18:27 local time (CET),[6] seven minutes after she had fallen into the water, they called for help on a mobile phone.[10] Police lieutenant Bård Mikkalsen received the call and put together two rescue teams; one at the top of the mountain and one at the bottom.[5] Mikkalsen also contacted the Bodø rescue team, which was equipped with a Sea King helicopter; they told him, however, that the helicopter had left to transport a sick child. Mikkalsen was persistent and convinced the dispatcher to turn the helicopter around.[5]

Falkenberg and Næsheim held onto Bågenholm's skis as they waited for the rescue teams to arrive.[3] When Bågenholm struggled in the cold water, she found an air pocket and was able to remain conscious for forty minutes before becoming clinically dead.[8] Ketil Singstad lead the rescue team from the top of the mountain. He skied as fast as he could to Bågenholm's location, where he and his rescue team unsuccessfully tried to pull her out with a rope.[5] They then tried to dig her out, but their snow shovel could not break through the ice. Rescuers from the bottom of the mountain soon arrived, and they brought with them a pointed gardening shovel. They were able to cut a hole in the ice and pulled her through[5] at 19:40.[6] Bågenholm had been in the water for eighty minutes when she was rescued.[3]

Resuscitation and recovery

A Sea King helicopter brought Bågenholm to the Tromsø University Hospital.

When Bågenholm was pulled out of the water, her pupils were dilated, her blood was not circulating,[3] and she was not breathing.[13] Falkenberg and Næsheim, both doctors, began giving her cardiopulmonary resuscitation (CPR) in an attempt to regain her pulse.[5] A rescue helicopter soon arrived and Bågenholm was brought to the Tromsø University Hospital in an hour.[3][14] The helicopter emergency team continued to give her CPR during the flight,[5][14][15] and she was ventilated with oxygen.[12][14] She was also treated with a defibrillator, but to no effect.[10]

Bågenholm arrived at the hospital at 21:10.[10][16] Her body temperature at the time was 13.7 °C (56.7 °F)[10][17]—the lowest survived body temperature ever recorded in a human.[3][12][18][19][20] Doctor Mads Gilbert, an anesthesiologist and the chief of the hospital's emergency room, proceeded the resuscitation attempt. He commented on Bågenholm's state: "She has completely dilated pupils. She is ashen, flaxen white. She's wet. She's ice cold when I touch her skin, and she looks absolutely dead."[5] Gilbert had treated many cases of hypothermia before because of the cold climate in Norway, and knew how to treat Bågenholm.[3] The electrocardiogram connected to her showed no signs of life,[5] but Gilbert knew patients should be "warmed up before you declare them dead."[21] He and his team hoped Bågenholm's brain had received enough oxygen from the CPR she was given after her rescue.[5]

Bågenholm was brought to the operation room, where a team of more than a hundred doctors and nurses worked for nine hours to save her life.[3] At 21:40,[6] she was connected to a cardiopulmonary bypass machine that warmed up her blood outside of her body[21][14] before it was reinserted into her veins.[13] Bågenholm's first heart beat was recorded at 22:15. Gilbert had been watching her heart on a video probe[5] and recalls crying at the moment it started beating.[10] At 0:49, her body temperature had risen to 36.4 °C (97.5 °F).[22] Bågenholm's lungs collapsed at 02:20,[6] and she had to spend the following thirty-five days connected to a ventilator.[12][21][23]

Bågenholm soon began to show signs of vitality and woke up paralyzed from the neck down[10] on 30 May.[6] She feared she would spend the rest of her life on her back, and was angry with her colleagues for saving her. Bågenholm soon recovered from the paralysis, however, and later apologized to her friends;[16] "I was very irritated when I realized they had saved me. I feared a meaningless life, without any dignity. Now I am very happy to be alive and want to apologize."[24] Bågenholm's kidneys and digestive system were not working properly,[3] so she had to recover in an intensive care unit for two more months.[3][12] After twenty-eight days, she was flown to Sweden in an ambulance helicopter for the remainder of her recovery.[8]

Doctor Petter Andreas Steen, professor at the National Hospital in Oslo, said it was "an extraordinary medical achievement" that Bågenholm's life could he saved. He believed the reason she was able to recover was that her metabolism slowed down during the incident and the tissues inside her body required less oxygen at the low temperatures.[25] According to the journal Proto Magazine by Massachusetts General Hospital, Bågenholm's metabolism slowed down to ten percent of "its baseline rate" and thus she barely needed any oxygen at all.[15]

Aftermath

Despite the severe damages to Bågenholm's body, she did not suffer any brain damage; Gilbert commented on this: "Her body had time to cool down completely before the heart stopped. Her brain was so cold when the heart stopped that the brain cells needed very little oxygen, so the brain could survive for quite a prolonged time."[3] Bågenholm's case and the cases of others who have survived extreme hypothermia have, according to The Sydney Morning Herald, "informed modern medicine to such an extent that cooling patients is emerging as a way to save victims of heart attack, head trauma, stroke and spinal cord injuries."[26]

Bågenholm returned to work in October 1999,[11] but she still suffered from nerve damage and was unable to use her hands normally.[3] On 7 October 1999—140 days after the accident—she returned to the hospital in Tromsø and got to meet the doctors and nurses that helped save her life.[10] Bågenholm commented: "When you are a patient, you're not thinking you are going to die. You think, I'm going to make it. But as a medical person, I think it's amazing that I'm alive."[3] As of October 2009, Bågenholm has made an almost full recovery, although minor nerve damage in her hands and feet remains.[8] She is now working as a radiologist at the hospital where her life was saved.[5][27] Bågenholm is currently in a relationship with Næsheim, and they are living together[5] in Tromsdalen.[1]

Gilbert said vigorous CPR plays an important role in the rescuing of victims of accidental hypothermia with circulatory arrest.

According to BBC News, most patients who suffer from extreme hypothermia die, even if doctors are able to re-start their hearts. The survival rate for adults whose body temperature has decreased to below 28 °C (82 °F) is 10%–33%.[12] Prior to Bågenholm's accident, the lowest survived body temperature was 14.4 °C (57.9 °F), which had been recorded in a child.[11][12] Gilbert said "victims of very deep accidental hypothermia with circulatory arrest should be seen as potentially resuscitable with a prospect of full recovery. The key success factors of such marginal resuscitation efforts are early bystander actions with vigorous CPR and early warning of the emergency system, early dispatch of adequate rescue units (ground and air-ambulances) and good co-ordination between the resources outside and inside the hospital, aggressive rewarming and a spirit not to give up."[12] General practitioner Jel Coward from Tywyn said persons who are victims of extreme hypothermia are often mistaken to be dead because it can be difficult to detect a pulse on them. He said this case "really does bring it home to us how cautious one has to be before diagnosing death in people who are cold."[12]

Bågenholm's story was featured on CNN's television program Another Day: Cheating Death on October 25, 2009.[8][28] Hosted by Sanjay Gupta, the program features stories from people who have survived severe conditions against all odds. Bågenholm hoped the program would give the people watching it more knowledge of hypothermia.[10] The story is also included in Gupta's companion book, Cheating Death: The Doctors and Medical Miracles that Are Saving Lives Against All Odds Years.[29] After the incident, Bågenholm has become the subject of several medical textbooks,[26] and she has appeared in The Lancet.[30]

References

  1. ^ a b c "Anna Elisabeth Johansson Bågenholm (1970) - Skattelister 2008". Aftenposten (in Norwegian). Retrieved 2009-10-25.
  2. ^ Schönstedt, Tommy (2005-05-09). "Temperaturen var nere i 20 grader". Expressen (in Swedish). Retrieved 2009-10-24.
  3. ^ a b c d e f g h i j k l m n "Frozen Woman: A 'Walking Miracle'". CBS News. 2000-02-03. Retrieved 2009-10-24.
  4. ^ Cañas, Gabriella (2000-01-29). "La mujer que venció a la muerte". El País (in Spanish). Retrieved 2009-10-24.
  5. ^ a b c d e f g h i j k l m n o Martin, David S. (2009-10-13). "From an icy slope, a medical miracle emerges". CNN. Retrieved 2009-10-24.
  6. ^ a b c d e f Österholm, Ulla-Lene (1999-10-07). "Hennes temp var nere i 13,8 grader". Aftonbladet (in Swedish). Retrieved 2009-10-24.
  7. ^ a b c "Hon lurade döden". Norrländska Socialdemokraten (in Swedish). 2006-04-08. Retrieved 2009-10-24.
  8. ^ a b c d e f g h Røed, Lars-Ludvig (2009-10-23). "Mirakelet under isen". Aftenposten (in Norwegian). Retrieved 2009-10-24.
  9. ^ "Hun er et mirakel". Verdens Gang (in Norwegian). 1999-10-06. Retrieved 2009-10-24.
  10. ^ a b c d e f g h i Bergfeldt, Carina (2009-10-24). "Mirakelräddningen". Aftonbladet (in Swedish). Retrieved 2009-10-24.
  11. ^ a b c Libedinsky, Juana (2000-01-31). "Resucitaron a una esquiadora que estuvo 40 minutos bajo el hielo". La Nación (in Spanish). Retrieved 2009-10-24.
  12. ^ a b c d e f g h i "Skier revived from clinical death". BBC News. 2000-01-28. Retrieved 2009-10-24.
  13. ^ a b Smith, Tom (2006-10-28). "Why do women live longer than men?". The Guardian. Retrieved 2009-10-24.
  14. ^ a b c d Von Judith, Innerhöfer (2007-05-23). "Der Mann, der sterben musste, um zu leben". Die Welt (in German). Retrieved 2009-10-25.
  15. ^ a b Schmidt, Charles (Spring 2008). "Dying to Live" (PDF). Proto Magazine. Massachusetts General Hospital. Retrieved 2009-10-26.
  16. ^ a b "Ice Woman returns from dead to ski again". The Straits Times. 2000-01-29. p. 18. {{cite news}}: |access-date= requires |url= (help)
  17. ^ The Canadian Press (2007-01-23). "Researchers plunge into hypothermia". The Record. p. D2. {{cite news}}: |access-date= requires |url= (help)
  18. ^ McLeodand, Kim (2001-02-27). "'Someone was on this little girl's side' - Doctor 'humbled' by recovery of frozen baby brought back to life". Toronto Star. p. A01. {{cite news}}: |access-date= requires |url= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)
  19. ^ Simon, Jane (2006-09-25). "We Love Telly! - Documentary Bodyshock C4, 9pm". Daily Mirror. {{cite news}}: |access-date= requires |url= (help)
  20. ^ Seddon, Eloise (2000-07-03). "Faster, higher deeper - it's the way to go". The Times. p. 27. {{cite news}}: |access-date= requires |url= (help)
  21. ^ a b c Reaney, Patricia (2000-01-29). "Frozen skier saved after being thawed". The Advertiser. p. 053. {{cite news}}: |access-date= requires |url= (help)
  22. ^ Von Brinkbäumer, Klaus (2007-02-17). "Ein perfekter Unfall". Der Spiegel (in German). Retrieved 2009-10-24.
  23. ^ Blackstock, Colin (2000-01-28). "Woman 'frozen' in lake brought back to life". The Guardian. Retrieved 2009-10-24.
  24. ^ Associated Press (1999-10-09). "Back from the dead, ice woman says sorry". Hobart Mercury. p. 014. {{cite news}}: |access-date= requires |url= (help)
  25. ^ "Coldest woman talks about her close call". Independent Online. 1999-10-06. Retrieved 2009-10-25.
  26. ^ a b Fallon, Mary (2009-07-09). "The cool way to treat trauma". The Sydney Morning Herald. Retrieved 2009-10-24.
  27. ^ "O retorno ao palco de um milagre". Zero Hora (in Portuguese). Grupo RBS. 2009-10-13. Retrieved 2009-10-25.
  28. ^ Godø, Knut (2009-10-25). "Overlevde kroppstemperatur på 13,7 grader". Harstad Tidende (in Norwegian). Retrieved 2009-10-25.
  29. ^ Lundborg, Zinta (2009-10-14). "To Cheat Death, Chill Out, Have Your Heart Attack in Las Vegas". Bloomberg L.P. Retrieved 2009-10-25.
  30. ^ "'No podía creer que no me hubiesen dejado morir'". La Nación (in Spanish). 2000-02-01. Retrieved 2009-10-25.
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