Terminal Burrowing

We’d be amazed if this ever popped up on the exam, and for goodness sake don’t blurt this out in a SCE, but it’s one of the more interesting bits of medical trivia we’ve stumbled across lately!

While this may be something you feel like doing about now, with only 3 weeks til the clinical exam, it is in fact a real medical phenomenon that we’ve only just learned about. In the final stages of lethal hypothermia it seems one of the primal brainstem repsonses is to burrow, like a hibernating animal. People have been found in wardrobes, under beds, under piles of leaves and this often makes it hard for rescuers to find victims.

In a recent case in the Victorian Alps a young man who was found outside in the snow (who had also undergone paradoxical undressing), was found with life threatening hypoythermia. Upon intubation there was dirt in his airway, and when a nasogastric was inserted dirt-stained stomach contents were aspirated. These were presumed to be from him “burrowing” into the dirt outside.

So there you go, its not all slow AF with shivering artefact and Osborne waves, minimsing handling and active rewarming. Remember, as with any resuscitation, if the patient is unconscious, look in the airway, you may be surprised by what you find!

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