Hypothermic Cardiac Arrest: A Case Report of an Unexpected Survivor Using Air Medical Transportation in Nepal.

Ashim Subedi, Kishor Khanal, Ashim Regmi, Sagarika Panday, Rupesh Yadav, Pritina Nakarmi, Enish Shrestha, Prashanti Prasai, Ryan McHenry, Sanjaya Karki

Air Medical Journal · 2023-12-27 · Case report

Read at publisher · PubMed

Abstract

This is a case of a 34-year-old man surviving hypothermic cardiac arrest with excellent neurologic recovery in Nepal. After 3 days without communication at an altitude of approximately 6,000 m, the patient was located in a crevasse and retrieved by a helicopter-supported search and rescue team. At first contact, he was reported to be breathing and shivering with appropriate pupillary response. The patient was then flown to a local teaching hospital where he was assessed on arrival and found to be in cardiac arrest with absence of spontaneous breathing and a central pulse and bilaterally fixed and dilated pupils. An electrocardiogram demonstrated asystole, and his core temperature was unrecordably low on the available device. After resuscitation and return of spontaneous circulation, the patient received a secondary helicopter transfer to a major hospital in the capital, Kathmandu, where his recovery continued. The report discusses the physiological basis of the relatively favorable outcomes observed in hypothermic cardiac arrest and highlights the operations and capability of helicopter emergency medical services in a country on the United Nations list of least developed nations.

Abstract © the authors or publisher, via PubMed. Reuse and removal

Tags

Helicopter & air ambulance

Related articles

• Noncompressible Chest Wall in Critically Buried Avalanche Victims with Cardiac Arrest: A Case Series. (High Alt Med Biol, 2025)
• Full recovery of an avalanche victim with profound hypothermia and prolonged cardiac arrest treated by extracorporeal re-warming. (Resuscitation, 2008)
• Management and outcome of patients with cardiac arrest after avalanche accidents in the Swiss Alps: A retrospective analysis. (Resusc Plus, 2025)
• Swedish-Norwegian co-operation in the treatment of three hypothermia victims: a case report. (Scand J Trauma Resusc Emerg Med, 2017)
• Prehospital Frostbite Management With Iloprost: Case Reports of Two Helicopter Evacuations in Northern Canada. (Wilderness Environ Med, 2026)
• Experience with helicopter rescue missions for crevasse accidents. (High Alt Med Biol, 2010)