The specialist speaks, after the case of the avalanche in Val Badia: «This way the joints are protected but there are more chances to defend the bones if the impacting force comes from the edge». Hypothermia and hypoxia the enemies to face
“When the avalanche hit me, I hardened my muscles because I was afraid that the driving force would sever my limbs,” he says. Carluccio Sartori, alive, after spending almost 20 hours half buried by an avalanche in Val Badia. The ski mountaineer landed in the snow lying upright and managed to pierce the snow with his right hand until he reached the surface. From that little hole he breathed and thus saved his life.
But can hardening your muscles actually prevent fractures? “It depends where the strength comes from. Tightening up your muscles can definitely keep your joints from getting damaged. There are more doubts about the bones because a blunt force sufficient, for example, to fracture a femur is probably able to do it even with a contracted muscle» he replies Matthew Cerri, professor of Physiology at the Department of Biomedical and Neuromotor Sciences of the University of Bologna. “However if the shear impact force instead of parallel, it will tend to rotate the bone, favoring a spiral gait. In this case, with an avalanche spinning the skier, it may be worth stiffening because the muscle helps hold the bone in place. But this is not always the case because in other circumstances the opposite occurs and just rotating the bone on the joint would prevent the fracture. Difficult to say beforehand and certainly in cases of emergency such as an avalanche one cannot stop and make calculations».
Carluccio Sartori went well. No fractures. Only the right hand, the one he hollowed out, will take longer to heal. «When you are hit by an avalanche, there are in fact two problems: immediately the air: when it is not there it is like being underwater; in the medium term thehypothermia which occurs as the time spent in the cold increases». Sartori was able to breathe thanks to the hole he dug while the effect of engulfing the snow allowed him to survive for 20 hours even with extremely cold temperatures of -10°.
If he hadn’t been able to breathe paradoxically even colder temperatures would have been desirable. «In extreme situations hypothermia should come before hypoxia: If the body cools down quickly enough before the lack of oxygen can cause damage, there may be some chance of saving it in the medium term. Paradoxically, a scantily clad person who cools down more quickly has a better chance of surviving for a long time, naturally without consciousness» explains Matteo Cerri, a member of the Topical Team Hibernation of the European Space Agency (ESA).
An emblematic case in scientific literature is the story of Anna Bågenholm: «resurrected» after hypothermic cardiac arrest in 1999. The woman, a medical student, after a skiing accident in Sweden ended up with her head stuck in a frozen stream, with legs out. Thanks to an air bubble under the ice she was able to breathe, but the freezing water soon soaked her clothes and her body temperature began to drop rapidly. The place was impervious, her friends could not get her out of her. The woman went in hypothermic cardiac arrest. When help arrived, hers was hers body temperature was 13° one of the lowest body temperatures ever recorded in a human with accidental hypothermia. Cardiopulmonary resuscitation was immediately performed. In the hospital she was put on a heart lung machine (ECMO), she was warmed up slowly. Fifteen minutes later her heart started beating again. The woman, who was a doctor, recovered and a year later she was back to leading a normal life.
Ironically, the cold nearly killed Anna but also saved her. In normal situations, with a temperature of 37°C, the brain begins to suffer irreversible damage if deprived of oxygen for more than twenty minutes. Anna’s very low temperatures, however, led to a progressive slowdown in the body’s metabolism, which probably allowed the brain to resist with much less oxygen. Anesthesiologists always say, “You’re not dead until you’re warm and dead; if you’re cold and dead there’s still some chance.’
February 2, 2023 (change February 3, 2023 | 09:03)
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