We present a case report of a helicopter pilot who fell into a crevasse during a fuel delivery in Antarctica. He was trapped alone in the crevasse for 3 h while waiting for a rescue team to arrive, and a further 1 h during the extrication process. His condition deteriorated during the extrication and he lost consciousness and signs of life minutes after being dragged over the lip of the crevasse. He was then loaded into the rescue helicopter and treated with intermittent cardiopulmonary resuscitation during the 39-min return flight. Initial esophageal temperature on arrival at the Davis Base medical facility was 24.2°C. After 18 h of further treatment (mechanical ventilation with warm humidified O2, with internal and external warming) he was pronounced dead. The cause of death was hypothermia with minimal physical injury. This case highlights some of the extra challenges facing operational, rescue, and medical personnel in an isolated location. These complications include the tendency for flight crew to remove cold weather clothing during flight due to restricted mobility and excessive heat load from cabin heating; extended time for arrival of the rescue crew; extrication in a confined space; limited helicopter cabin space for transporting the rescue team and their rescue and medical equipment; and extended transport time to the nearest medical facility.
Keywords: cardiac arrest; cold exposure; hypothermia; insulation; rescue collapse.
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