Six-year-old Arian from Lower Saxony has been missing for a week now. Emergency physician Gernot Rücker from the Rostock University Medical Center explains what the chances of survival are and what is important if the boy is found.
What dangers does a child like Arian, who has been missing outdoors for a week, face?
From an emergency medicine perspective, there are three problems: cold, thirst and hunger.
Which of them weighs the heaviest?
It takes up to 20 days for someone to starve to death. For children it may happen a little faster, but not in seven days. When it comes to thirst, things are different: the body’s water reserves last for three to five days. However, since water is available everywhere in this country and especially in the forest, the likelihood of such a child dying of thirst is relatively low.
You mean the water from puddles, ponds and rivers?
Yes, they are sufficient as a water source. It is hoped that the child will recognize and accept these water sources as such. From a purely physical perspective, it is easily possible for the boy to survive a week like that. About a year ago there was a case in the Colombian jungle where four children survived for 40 days.
The main thing is that you drink something, even if the water is possibly contaminated?
Yes, the main thing is water. We’re talking about puddles, there might be fresh rainwater in them. Or smaller streams that are often found in the forest.
What about the problem of cold?
In my opinion, hypothermia is the biggest problem. As soon as cold and wet conditions are involved, survival is difficult. Anyone who is wet and hypothermic can freeze to death within a few hours. The boy is walking in socks, which is inconvenient: the ground is cold and he can cool down quickly. But the frost is now over and the temperatures are rising, so it is definitely advisable to continue looking for the boy.
What happens to the body when it is hypothermic?
A body temperature above 35 degrees is normal. With a body temperature of 32 to 35 degrees, a person is already somewhat restricted. Below 32 degrees it starts to become critical. Blood pressure drops, the heart beats slower, and the body goes into a kind of cold sleep. What is dangerous is the side effect, the so-called cold idiocy, as it is called in medical terminology.
What is this side effect?
This is a condition in which those affected seem to be out of their minds. For example, some people then start to take off their clothes. During hypothermia, the vessels in the extremities contract sharply to protect the organism. The blood is then only transported to the vital organs. In this condition he can no longer help himself and ultimately no longer move
What else can this condition do?
It increases the risk of accidents. People in this state may find themselves walking into a river instead of running parallel to the bank. Or that they stumble into a puddle. In these cases we would have the problem of cold and humidity.
On Tuesday night the temperatures in Bremervörde were around freezing point. The missing boy is traveling in a sweater. Can you survive a night like that?
Yes, it may be that he was still on the move. That he sought protection. That he hid in a bush or protected himself with leaves or branches. He may meet an animal such as a dog that he can warm himself to. This is theoretically possible. Surviving a night like this is possible. If such a child finds protection, he or she can easily survive for 14 days or longer.
Does a child get hypothermic faster than an adult?
Yes, because the body proportions are distributed differently and the body is smaller.
What happens when you freeze?
You end up falling asleep.
How should you behave if you see a possibly hypothermic child lying in the forest?
Do nothing, don’t touch it and alert the emergency services! Every rescue team in Germany knows how to deal with it.
Why shouldn’t you do anything?
The core of the body maintains the temperature for a while, while the extremities and the outer area of the body, we call it the body shell, are cold. If you startle a child like this, it can happen that the cold blood from outside flows into the center of the body due to the body movement and triggers a cardiac arrest. This is called an afterdrop. And that can lead to death.
Pictures of the operation
1,200 emergency services are searching for missing Arian with a large human chain
What if I, as a passer-by,… Hypothermia don’t recognize?
If the child collapses, be sure to check vital signs and begin resuscitation immediately. Even with an afterdrop you have a very good chance of survival in Germany. In clinics with heart surgery, the affected person can be treated with a heart-lung machine and the body can be warmed up again.
How does this work exactly?
The heart-lung machine then takes over the heart function, because it will not start beating again as long as it is cold. The same thing is sometimes done during open heart surgery. You can’t darn ten socks in strong winds. This has the advantage that it does not consume any energy and cells do not perish so quickly. The cells are thus preserved. The device takes over the circulation – until the heart starts again and the body has a normal temperature again.
How long can a heart stop before it starts beating again?
There are always cases in which patients have survived with excellent quality of life despite a very long cardiac arrest period of several hours under resuscitation. If a person affected is taken to the hospital within an hour of the afterdrop, and that is a realistic time, then the chances of survival are very good.