What is ‘rescue death’?

There are people who survived the earthquake in Turkey or in Syria, trapped under the rubble, waited days to be rescued, and were saved — only to die shortly afterward. Why is this?

Following the devastating earthquake in Turkey, Zeynep was trapped for more than 100 hours under the ruins of a collapsed house before rescue workers finally managed to free her. At that point, a press release from the aid organization ISAR Germany (International Search and Rescue), which helped recover her, said: “The woman is doing well, under the circumstances.”

But Zeynep died shortly afterwards. “On the way to hospital, she was laughing,” says the emergency doctor Bastian Herbst, one of the ISAR doctors who helped free Zeynep from the rubble.

There could be a thousand and one reasons why she died, Herbst says. Internal injuries, for example, that would only be diagnosed later on. But hers may also have been what is commonly referred to as a “rescue death.”

Cold blood a cause of death?

“There are various causes of rescue death,” Herbst explains. Hypothermia is one. Icy temperatures, like those in the earthquake zone, cause the blood vessels in buried victims to constrict. It’s the body’s way of making sure that as little as possible of its existing warmth is lost from the skin or the extremities. The temperature of the blood drops in those parts, while the warm blood at the core of the body ensures the continued functioning of the vital organs.

Zeynep’s recovery was complicated. “We had to move her around a lot in order to free her,” explains Herbst. He says that blood vessels can dilate in the process, causing cold blood to flow to the core of the body, and that this can cause cardiac arrhythmia, resulting in death.

Kidney damage and ventricular fibrillation

“Her legs were buried beneath stones and rubble,” Herbst says, describing the situation Zeynep was in. She was able to move her feet, he says, but it was very possible that the tissues in her legs were damaged by debris. When muscles are injured, the body releases myoglobin, a protein responsible for transporting oxygen within muscle cells.

When buried victims are freed, blood is suddenly able to flow freely again, and may flood the body with myoglobin. “This damages the kidneys,” says Herbst. It can lead to kidney failure, which causes potassium levels to rise. Too much potassium in the blood can in turn lead to ventricular fibrillation, which is especially dangerous for people with pre-existing heart conditions.

Reduction in stress results in death

“We see this in shipwrecked people. The moment they see the rescue team, they can’t take it anymore, and drown,” Herbst says. He explains that stress hormones ensure that organ functions are maintained, and that, with the rescue, a reduction in stress can result in circulatory collapse.

Zeynep’s husband and children were killed in the earthquake. “Perhaps she realized this, and it robbed her of the will to live,” says Bastian Herbst. “We just don’t know.”

This article has been translated from German.

Author: Julia Vergin

Leave a Reply

Your email address will not be published. Required fields are marked *