Hypothermia Rescue: Cardiac Arrest in a Tree Well

What happens when a 24-year-old woman is found frozen in a tree well after last being seen 8 hours prior, with a core temperature of 62°F (17°C)? In this extraordinary case, paramedic Miles Randell and his team performed 4 hours of CPR in knee-deep snow on April Fool's Day 2014—and she walked away with zero neurological deficits. This wasn't luck. Miles breaks down the critical decision to defy transport protocols and how they managed a failed field intubation when her torso sank into the snow during compressions. The case became a catalyst for building Teaam Aeromedical, a progressive nonprofit wilderness air ambulance saves time, lives, and healthcare dollars. Learn the physiology of hypothermic cardiac arrest, why less intervention is sometimes more, and how to package patients in snow to prevent further heat loss. Whether you work in wilderness medicine or urban EMS, the principles here apply: know the science, challenge protocols when they don't serve your patient, and get them to the right place at the right time. Interested in The Loud & Clear Fellowship course? Check us out at - emspodcast.com Guest/Cast/Crew information- Guest- Miles Randell, Paramedic, Founder of TEAAM Aeromedical, for more go to teaam.ca  Host- Ross Orpet   Catch up with us after the show - Instagram- @emsloudandclear - YouTube- https://www.youtube.com/@EMSLoudandClear - Website- www.emspodcast.com   Want to stay ahead of the top 1% in EMS and build real confidence in the field? 👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: emspodcast.com/free-coaching-call 📰 Join our bi-weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae American Burn Association / ABLS: Enter the ABLS giveaway by June 30, 2026; the winner will be selected July 1, 2026. Loud & Clear listeners also get 10% off ABLS Now through August 31, 2026. Details: https://bit.ly/aba-loud-clear