Severe Hypothermia and Frostbite Requiring ECMO and Four Limb Amputations

Area of Science:

• Emergency Medicine
• Traumatology
• Critical Care Medicine

Background:

• Severe hypothermia and frostbite pose significant risks of morbidity and mortality.
• Cold exposure injuries often result from accidents, such as snowmobile crashes.

Observation:

• A patient presented with cardiac arrest and a core body temperature of 19°C following a snowmobile accident.
• The patient required extensive medical interventions, including prolonged cardiopulmonary resuscitation, active internal rewarming, and venoarterial extracorporeal membrane oxygenation.

Findings:

• Despite the critical condition, the patient underwent successful treatment, including amputations of all four extremities.
• A good neurological outcome was achieved, demonstrating the possibility of recovery even in extreme cases.

Implications:

• This case underscores the critical role of a coordinated interdisciplinary team in managing severe hypothermia and frostbite.
• Effective management requires rapid intervention by Emergency Medical Services, emergency physicians, trauma surgeons, cardiothoracic surgeons, intensivists, and burn specialists.
• Successful outcomes in severe cold exposure injuries depend on timely and comprehensive medical care.