June 09--The unusually cold, snowy spring Chippewa Valley residents endured likely helped save the life of the Eau Claire boy who was clinically dead last weekend when rescuers pulled him out of a van submerged in a Lake Hallie stretch of the Chippewa River.
The chilly water -- Xcel Energy estimates the temperature is in the mid-60s -- is one of several factors experts say aligned perfectly for the seemingly miraculous revival of 3-year-old Logan Buchli after he spent an estimated six to eight minutes trapped underwater in the van.
The boy, who had no pulse and was no longer breathing by the time bystanders were able to break a window and retrieve him, was discharged Friday from St. Marys Hospital in Rochester, Minn., and returned home, said his mother, Kayla Tanner of Eau Claire.
"He's walking and running around like nothing ever happened," Tanner said. "It was like he was kissed by angels."
But while friends and relatives are hailing Logan's revival as a miracle, a leading national expert on the resuscitation of people who apparently have died of drowning in cold water said there is a proven medical explanation for the boy's recovery.
"Miracle is the word most often used for these cases in newspapers, but it's no miracle at all," said Dr. Martin Nemiroff, a retired former Coast Guard flight surgeon in Alaska. "It's actually not a surprise."
The explanation, Nemiroff said, comes from a natural human response to immersion in cold water. It's called the mammalian diving reflex and is similar to what seals, whales and dolphins rely on to dive underwater for extended periods to catch fish.
Survival mode
The diving reflex, the body's physiological response to submersion in cold water, exists in humans as a survival mechanism. It involves parts of the body shutting down to conserve energy for survival and the heart rate and metabolism slowing dramatically to decrease the body's oxygen requirement, according to a 2012 article in Dartmouth University's Undergraduate Journal of Science.
"It turns out that water temperatures below 70 degrees (as the Chippewa River still is) are necessary for this to occur," Nemiroff said.
Logan was in his dad's red Chevrolet Astro van that rolled into the fast-flowing Chippewa River at about 5 p.m. June 1 at the boat landing next to Lake Hallie Sportsman's Club, 2910 109th St., while family members were trying to remove a boat from the water after a brief outing on the river. The boy's uncle, Quentin Buchli, 34, of Eau Claire, was able to retrieve Logan's 5-year-old sister, Siren Buchli, as the van entered the river, but Logan was still inside, according to Lake Hallie police.
Nemiroff said he personally was involved in at least 50 near-drowning cases very similar to Logan's during his 20-year career with the Coast Guard. Several of those cases involved patients who were submerged for at least an hour, he said, jokingly referring to Logan's case as a "shorty."
"The shorter the time underwater, the younger the age and the colder the water, the better the chance of survival," Nemiroff said, recalling that most of his revived patients were younger than 12.
As people grow older, the diving reflex grows less and less active, typically almost disappearing by the time people reach their late teens, said Nemiroff, now retired and living in Sonoma, Calif.
Youth's advantage
The Dartmouth University article explains that children have a survival advantage because their small bodies have a higher surface-area-to-volume ratio than adults, allowing them to cool faster -- the same way a cupcake just out of the oven cools faster than a sheet cake.
Children also have the innate ability to absorb more oxygen into their bloodstream than adults do, giving them more oxygen to draw from when they go underwater, and a better ability to create new brain connections and thus bounce back from any potential brain damage, the article indicates.
Another key factor improving survival chances for extended submersion patients is prompt and appropriate CPR once the person is removed from the water to keep oxygen circulating to the brain, Nemiroff said.
In the Chippewa River case, two bystanders, Branden Linhart and Shannan Brown, administered CPR on the riverbank immediately after Logan was retrieved from the van. Jesse Morley, a bartender at nearby Lake Hallie Sportsman's Club, went into the river and got Logan out of the van with the help of Linhart -- who dived to the river bottom to get large rocks used to break the van's rear window -- and Benjamin Prince. The child then was turned over to Hallie police Officer Tim Bowman and Chippewa Fire District Deputy Chief John Andersen, both of whom continued CPR until paramedics arrived and transported Logan by ambulance to Mayo Clinic Health System in Eau Claire.
Emergency responders followed a cold water drowning protocol -- including CPR, high-flow oxygen, warmed fluids and careful monitoring of the heart -- because of the exceptionally cold temperatures and late snow melt in the region, Andersen said.
"That water was ice cold," he said, "and in this case that was a really good thing."
Potential error
Unfortunately, all submersion patients aren't so lucky because of the dire appearance of their condition to bystanders and sometimes even medical personnel, Nemiroff said.
"The patients look dead at the scene, so more often than not CPR isn't done or is stopped too soon," he said, noting it can take two to three hours of CPR or machine resuscitation to revive some patients.
In Logan's case, paramedics saw improvement even before he got to the hospital just 34 minutes after the original 911 call was received by Chippewa County dispatchers, Andersen said. That was well within the so-called "golden hour," or the first hour after a trauma during which outcomes tend to be the best if a patient reaches the hospital in that period.
Hospitals then have access to equipment that can gradually warm a cold water near-drowning victim, limiting the shock to the system from another sudden temperature change, and drugs to keep the patient in a medically induced coma to allow the brain time to recover, Andersen said.
"The little guy was pretty cold," he said of Logan. "And the classic saying for emergency responders is that you aren't dead until you're warm and dead."
Direct knowledge
In 33 years as an emergency medical technician, Andersen has seen just enough of these amazing recovery stories to recognize the truth of that statement.
He also participated in a famous December 1979 case in which a seemingly lifeless 11-year-old Darven Miller was revived and enjoyed a complete recovery after falling through the ice and spending 50 minutes under the cold water of the Duncan Creek mill pond in Chippewa Falls. Andersen also recalled a case involving a Canadian boy revived after being hit by a boat in Lake Wissota.
"No matter how many years I've been doing this, though, it's still miraculous to me when that happens," Andersen said.
The diving reflex usually doesn't kick in when patients sustain traumatic injuries in connection with their submersion, Nemiroff said, making Logan's gradual slide into the Chippewa River inside a van a textbook case for good revival odds.
The boy also was fortunate because the incident took place in daylight and the van got caught up on a tree branch about 100 feet downstream from the boat landing, where it was still barely visible to bystanders and accessible for rescuers, who didn't have to waste time finding him, Andersen said.
"If that van hadn't gotten hung up where it did and floated farther down river, the next best access spot would have been (about a mile downstream) on 86th or 87th Street," Andersen said. "And that's if it would have remained buoyant."
That was just one of many factors -- including the water temperature, the victim's age, the quick rescue by bystanders willing to risk their own lives by diving into the surging river and the timely response by emergency crews -- that led to Logan's positive outcome.
"There were a lot of things very much working in this young man's favor that day," said Andersen, who was thrilled to see media reports about Logan's progress.
"Kids deserve a second chance," Andersen said. "This little guy has one, and I hope it works out really, really well for him."
Lindquist can be reached at 715-833-9209, 800-236-7077 or [email protected].
Copyright 2013 - The Leader-Telegram, Eau Claire, Wis.
