Back to life after frozen to death

Anna Bagenholm of Norway was submerged in icy water for well over an hour after a skiing accident. Anna's story of survival against the odds is amazing. She is a young doctor and a passionate skier. In May 2000, while out skiing with two friends near Narvik in the north of Norway, she slipped and fell through the ice covering a waterfall and fell head first into the icy water. Her head and body became wedged under thick ice and her friends could not free her.

The unfortunate skier got stuck but found an air pocket under the ice and struggled for 40 minutes before she fell still. Her companions called help but it was another 40 minutes before two rescuers, her medical colleagues, cut a hole in the ice and dragged her out downstream. Then Anna was ventilated with oxygen and given cardiopulmonary resuscitation (CPR) during a one-hour flight to hospital. By the time she arrived in hospital she was clinically dead. The hospital personnel had been notified immediately after the accident and started to prepare. They assumed, of course, that Anna would be extremely cold and probably without any signs of life on arrival. She arrived at ten past nine in the evening, by which time the hospital was fully prepared to receive the emergency case. Anna's body temperature fell to previously unrecorded levels to 13,7 degrees Celsius. Once in hospital, she was warmed up using cardiopulmonary bypass. This allows the blood to be circulated and re-warmed outside the body by a machine that mimics the action of the heart and lungs.

Anna was apparently dead, as her consciousness, heartbeat, breathing and all reflexes were absent. Medics continued the resuscitation that had been started by the rescue team. Active re-warming was accomplished by placing Anna in a circulating warm water bath. This surface warming brought about a rapid increase in body heat and improved heart output. Tubes were put into her blood vessels so that part of her blood volume could be warmed up outside the body and re-infused soon afterwards. After six hours in the operating theatre, Anna showed the first symptoms of returning to life. For the following 35 days she stayed on a ventilator and in the intensive care unit for another 2 months. By then it was clear that she would pull through.

Anna survived, but her recovery continues. She does not remember anything about the accident, nor the two days preceding it. Her amnesia lasted for two weeks after the event. Anna has problems with the nerves in her arms and legs since they were damaged by the cold. But there is a chance of these nerve endings coming back to some kind of normality. The mere fact that some months later she went skiing in Canada for a week, and that there has been a remarkable recuperation so far, means that she may make a full recovery. Eight months on and the only lasting effect is a tingling in her hands. Anna does not yet know if her career as a doctor will continue. She used to work as a surgeon, but now she says there is nobody, hardly surprisingly, who would like to be operated on by her for some time. But the skiing will go on.

This case really does bring it home to us how cautious one has to be before diagnosing death in people who are cold. “Nobody should be declared dead until they are warm and dead” goes the old saying and Anna Bagenholm’s incredible story best proves that.

Try to answer these questions about this extraordinary survival.

¨ How long after the accident did Anna show the first signs of life?

¨ Did she suffer any loss of memory? If yes, give details.

¨ In what sense was Anna’s case declared a world record?

¨ What are the chances of her full recovery?

Do you think she could ever go back to her original profession?