Barnum native helped pioneer method of reviving victims following cold-water rescues
CLOQUET -- As doctors in a Minneapolis hospital battle to save the life of an 8-year-old boy whose family sailboat capsized on a northern Minnesota lake April 6, a Barnum native and medical pioneer knows all too well the challenges to be faced.
Dr. William Norberg Jr., a pediatric cardiologist/ critical care specialist, graduated from Barnum High School in 1960 and the University of Minnesota Medical School in 1967. He was practicing in Fargo, N.D., when he became a pivotal player in a similar drama 25 years ago - one that set the early standards for use of a heart-lung machine in reviving victims of near-drowning incidents rescued from freezing water.
That incident took place after an 11-year-old boy fell through the thin ice of the Red River between Fargo and Moorhead and disappeared from sight. His friends ran to call 911 and firefighters and rescue crews arrived on the scene within minutes. Due to treacherous conditions, however, some 45 minutes passed before rescue personnel were able to retrieve the body of the young boy, Alvaro Garza Jr. - who was deemed technically dead at the time - from the bottom of the river.
He was rushed by ambulance to the nearby St. Luke's Hospital in Fargo, where he was administered to by a team of medical specialists headed by Norberg.
"When he came out of the river, he met the criteria for death," Norberg later stated on the reality show "Rescue 911," who did one of its pilot episodes about the dramatic rescue. "There was no pulse."
Norberg said the boy's body functions gradually slowed until they stopped while he was submerged in the icy river. It was later thought that the extreme cold of the water actually helped the boy's chances because it triggered an oxygen-conserving response that shut down all but the body's most critical functions.
At the time the boy arrived at the hospital, he had a body temperature of 80 degrees, no heartbeat for up to 10 minutes after arriving in the emergency room, and showed no signs of respiration or brain activity.
Norberg reported the boy's heart was "stiff, hard and cold" at the time. The team made an incision in the boy's chest and placed him on total life support by inserting a heart-lung bypass machine - the kind of device used for open-heart surgery. The boy's blood was then pumped through a special filter to help warm it as quickly as possible, not only to restart the heart but slow the injury process as well. Norberg said gradually the boy's heart began to "pink up" in color and eventually started beating faintly once again.
"By rewarming and controlling the circulation," Norberg stated on the segment of "Rescue 911," "we were able to revive him. It was truly life back from the dead."
Approximately two weeks following the incident, Garza Jr. was released from the hospital, and today he is living in Del Rio, Texas, and is the father of four children.
From his home in McAllen, Texas, on Tuesday, Norberg said though both Garza Jr. and the boy in last Friday's tragedy were submerged in icy water for approximately the same amount of time, it would be difficult to draw exact parallels between that December 1987 incident and the one last week near that left two young boys dead from hypothermia and the third in critical condition.
"Most medical procedures have standard operating protocols derived from evidence-based medicine," said Norberg. "In other words, physicians rely on prior experience to make up a plan for appropriate therapy. This sort of incident happens so seldom, however, that there are no long studies and scientific backups in place."
Norberg said the first heart-lung pump was utilized at the University of Minnesota in 1957 and has only been used periodically since that time for victims suffering hypothermia after prolonged submersion in water.
"The conditions have to be perfect for it to be effective in such incidents," said Norberg. "Often, distance and time can be a real problem."
The boy in last week's incident was taken to a Bemidji hospital and then airlifted to Minneapolis. In the case of Garza Jr., however, Norberg said the incident occurred only about two minutes from the hospital and eight minutes away from his office, so he and his team were able to react prior to the time the boy was brought to the emergency room. He had also established a protocol prior to the incident that asked EMS personnel to relay pertinent information on an incident directly to the experts so they were able to "rev up" their resources prior to the patient's arrival at the hospital and "go full tilt right away."
"Timing in these cases is critically important," he said. "You have to make sure all of the resources are available ahead of time, along with people who know what's going on and are able to invest the time and effort when these sorts of things happen."
Norberg admitted that since the effectiveness of the heart-lung procedure in reviving victims of extended cold water submersion is so exacting and extremely expensive, it is not widely used today.
"Warming the body slowly is the time-honored way of doing it," he said, "though the option of the heart-lung machine is faster and more absolute, but there really haven't been enough comparisons to be able to determine which is the better way. As a physician, you just have to try to make the best decision at the moment."
A news release last week stated the body temperature of the boy involved in last week's sailboat accident was near normal by Wednesday and he remained on a ventilator, though his kidney and liver function reportedly had shown some signs of improvement. Doctors say it could be several days or more until it's clear whether he'll have permanent brain damage due to oxygen deprivation or if he will be able to function normally once again.
WENDY JOHNSON is a writer for the Cloquet Pine Journal. The Bemidji Pioneer and the Pine Journal are Forum Communications Co. newspapers.