A drop in core temperature due to exposure to severe cold can slow the metabolism so much that a person can appear to be dead, say doctors, who believe that was likely the case with a newborn girl who had been declared dead on the weekend but "came back" to life.
The infant was born on a Toronto sidewalk Sunday after her mother went into labour while walking to the hospital. Mother and child were rushed to Humber River Hospital for treatment but the baby had no apparent vital signs and was declared dead.
About 90 minutes later, two police officers standing by the infant while waiting for the coroner to arrive suddenly noticed that a sheet covering the tiny body was moving.
The newborn was alive.
The officer found a pulse and alerted doctors. The baby girl was transferred to the Hospital for Sick Children, where she was in fair condition Tuesday, meaning she is conscious and may have minor complications, but has a favourable outlook.
Dr. Jamie Hutchison, an intensive care physician at Sick Kids, said the newborn likely had hypothermia, a condition in which the body is rapidly cooled, leading to a dramatic slowing of metabolism, which in some cases can mimic death.
"That would be the most likely reason," Hutchison, who was not involved in the newborn's care but conducts hypothermia research, said Tuesday.
"And that's because the body requires a certain temperature for metabolism to occur. So with each degree drop in temperature, the metabolism of every organ slows."
Whether hypothermia occurs in a child or adult, once their body temperature drops below a certain threshold, the person appears to be comatose, he said. And if they get cold enough, the heart beat will slow and weaken so much that they have no perceptible pulse.
"They're not dead, but they appear that way," Hutchison said.
The phenomenon has given rise to a saying in medical practice: "A patient isn't declared dead until they're warm and dead."
"That's what the mantra is now, you don't give up until the patient's warm and declared dead," said Gary Sieck, an expert in hypothermia at the Mayo Clinic in Rochester, Minn.
In other words, medical practitioners shouldn't assume a patient exposed to frigid temperatures is dead because their body is cold.