A Pennsylvania man's tale of survival is drawing attention to the dangers of cold weather exposure after a walk home in subzero temperatures left him unconscious, with no pulse when he was found in the snow the following day. 
 
 Justin Smith, 26, was walking home in below freezing temperatures after having a few beers with friends last winter when he blacked out, according to the Lehigh Valley Health Network. The college student was in the snow for hours as temperatures plunged to 4 degrees Fahrenheit below zero. 
 
 He wasn't found until the next morning, when his father Don Smith saw his son lying by the road. 
 
 "He was blue his face, he was lifeless. I checked for a pulse, I checked for a heartbeat, there was nothing," Don Smith told ABC affiliate WNEP. 
 
 Nearly a year after the ordeal, Justin Smith was finally healthy enough to thank his doctors in person at a news conference on Monday. His doctors said Smith's incredible tale of survival may affect how they treat other hypothermic patients in the future. 
 
 When Don Smith called paramedics after finding his son unconscious in the snow, they did not give up on the student. They started CPR with chest compressions. 
 
 Dr. Gerald Coleman, an emergency medicine physician at Lehigh Valley Hospital in Hazleton, Pennsylvania, had Smith rushed to the hospital for care. 
 
 "You're not dead until you're warm and dead," Coleman said on the Lehigh Valley Health Network website -- referring to a phenomenon in which people who are kept at cold temperatures can be revived despite a lack of vital signs. 
 
 When Smith was brought into the emergency room, Coleman couldn't even get an accurate body temperature reading because Smith was too cold. But the doctor did not give up. He transferred Smith via helicopter to a hospital where he could be hooked up to a machine called an ECMO (extracorporeal membrane oxygenation), which warms the blood and oxygenates it then pumps it back into the body. 
 
 Dr. James Wu, a cardiothoracic surgeon at Leigh Valley Hospital at Cedar Crest, said it was a still a long shot that Smith could survive but after the machine was turned on, within 90 minutes his heart was beating on his own. 
 
 “With very low temperatures, it can preserve the brain and other organ functions," Wu said at a news conference on Monday. 
 
 In spite of his nearly miraculous survival, Smith didn't wake up immediately. Doctors were concerned he could have had serious brain damage. He also had severe frost bite and lost his toes and pinkies due to frostbite. 
 
 Approximately 30 days after he was found with no pulse, Smith woke up in a hospital room surrounded by family. He now is back at school at Penn State and aims to get a degree in psychology. 
 
 "It’s amazing," Smith said at the news conference about his survival. "It’s something I never heard of and I can’t thank everyone enough.” ||||| SALISBURY TOWNSHIP — With his wide blue eyes, unruly hair and bashful grin, 26-year-old Justin Smith looks perpetually, happily surprised. 
 
 Doctors at Lehigh Valley Health Network describe the Penn State student from McAdoo, Schuylkill County, as a "medical miracle," perhaps the only person in history to survive hypothermia so extreme that he was literally frozen solid after falling unconscious in a snow bank while walking home in subzero temperatures. 
 
 "It's still sinking in, I guess, so it's hard to think of it as a miracle," Smith said. "I'm lucky. That's all I can say." 
 
 Smith and his family traveled to Salisbury Township Monday to thank the doctors and nurses at LVHN who saved his life. His father, Don Smith, wept as he described finding his son in the snow on the morning of Feb. 21. 
 
 "I remember holding him. He was so cold, frozen. He was like a block of concrete," he said. 
 
 Justin Smith's ordeal began around 9:30 p.m. Feb. 20, as he was walking home from the Tresckow Fire Company, a social hall where he and his friends often spent Friday nights having a few drinks. 
 
 PHOTO GALLERY: Justin Smith, a McAdoo man who escaped near-certain death from the bitter cold last winter, returned to Lehigh Valley Hospital’s Cedar Crest campus to thank caregivers for saving his life. Justin defied all odds and is alive today to tell his story. (DOUGLAS KILPATRICK / SPECIAL TO THE MORNING CALL) (DOUGLAS KILPATRICK / SPECIAL TO THE MORNING CALL) 
 
 It was a 2-mile trek that Smith had made countless times, he said, to avoid drinking and driving. Smith does not recall slipping and hitting his head, but doctors believe that's what happened as he walked along Tresckow Road. 
 
 He landed face up in a snow bank, eyes open, staring at the sky. 
 
 That's how Don Smith, a Hazleton Area High School teacher, found his son the next morning around 7:30 a.m., alerted by one of Justin's friends who had called to say that she had not heard from him and was worried. The temperature overnight had fallen to 4 below zero. 
 
 Don Smith gathered his son in his arms and sobbed as he rocked back and forth in the snow. Justin wasn't breathing and had no pulse. His eyes were still open and his arms and his feet had turned black from the cold. 
 
 "I just kept praying to the Lord, 'Bring him back, just bring him back'," Don Smith said. 
 
 Paramedics believed Justin Smith was dead and called the coroner. A sheet was pulled over his head. 
 
 Dr. Gerald Coleman, an emergency room doctor at LVHN's Hazleton campus, urged paramedics to transport Smith by helicopter to LVH-Cedar Crest, where he was revived with a procedure called extracorporeal membrane oxygenation in which blood is removed, oxygenated and warmed, then returned to the body. 
 
 Dr. James Wu, a cardiothoracic surgeon, performed the delicate procedure, which is typically used to save patients whose lungs and heart are damaged by the flu or a heart attack. 
 
 Smith spent the next 15 days in a coma. When he woke up, doctors were amazed to find that he had suffered no apparent brain damage. 
 
 "This case has taught me that sometimes you have to go with your gut, even when all logic demands otherwise," Coleman said. 
 
 Both of Smith's pinkie fingers and all of his toes had to be amputated because of frostbite. But the damage could have been far worse, said Dr. John Castaldo, a neurologist at LVH. 
 
 While extreme cold can preserve organs by putting the human body in a state of suspended animation, Castaldo said, once ice crystals form in the blood stream, death soon follows. 
 
 "Justin was right on the brink," Castaldo said. 
 
 Smith spent nearly three months at LVH-Cedar Crest and at Good Shepherd Rehabilitation Hospital in Allentown before returning home May 1. 
 
 Smith, who had studied at Penn State's main campus, is now finishing his psychology degree via online classes. On weekends, he works to improve his golf game, a challenge because of his lost fingers and toes. 
 
 Smith's mother, Sissy, and sisters Ashley and Sarah have been by his side throughout his recovery. His friends are glad to have him back, he said, and he's earned the nickname "Iceman" from his buddies. 
 
 As he took turns Monday hugging the LVHN doctors and nurses who had saved his life, Smith said the enormity of what happened to him hasn't sunk in yet. 
 
 "I'm just grateful. I'm proof of what can happen when great people work together," he said. 
 
 lmason@mcall.com 
 
 Twitter @LehighCourts 
 
 610-820-6506 ||||| "We knew we needed a big, big miracle." Those words from Pennsylvania mom Sissy Smith suggest just how grim the prospects seemed for her 26-year-old son, Justin, who was found unconscious and frozen after a night out in subzero temperatures last winter. 
 
 Somehow they got that miracle -- and Justin, who was on the verge of being declared dead, not only survived but is thriving and returned to the hospital this week to thank those who saved his life. 
 
 The story began in February 2015 when Justin Smith was walking home after a night out at a bar with friends. He doesn't remember what happened, but doctors believe he must have slipped, hit his head and fallen onto a snowbank, The Morning Call newspaper reports. His father found him there the next morning after 12 hours exposed to the elements. The temperature overnight had fallen to 4 degrees below zero, the paper reports. 
 
 "I looked over and there was Justin laying there and he was laying face up there like this," Don Smith told WNEP-TV. "He was blue. His face he was lifeless. I checked for a pulse. I checked for a heartbeat. There was nothing." 
 
 Justin Smith was found unconscious and frozen along this road near his home in McAdoo, Pennsylvania, in February 2015. WNEP-TV 
 
 "The coroner was on scene. The state police were on scene. They were doing essentially a death investigation," Dr. Gerald Coleman recalls. 
 
 But Coleman, an emergency department physician at Lehigh Valley Hospital in Hazleton, Pennsylvania, refused to give up and had paramedics transfer Justin to Lehigh Valley Hospital Cedar Crest, near Allentown. 
 
 Dr. Gerald Coleman. WNEP-TV 
 
 There, doctors hooked him up to what's called an ECMO machine to warm up Justin's blood. ECMO -- which stands for extracorporeal membrane oxygenation -- is a treatment that uses a pump to circulate blood through a machine that warms and restores oxygen to it and then return it back into the bloodstream. 
 
 Eventually his heart started beating again. But Smith remained in a coma for the next 15 days. When he finally woke up, The Morning Call reports doctors were amazed that he did not seem to have suffered any brain damage. 
 
 "When you look at the science of what happened to Justin, it was really hard to imagine that anyone on Earth could survive this," Dr. John Castaldo told WNEP-TV. Dr. James Wu of the Lehigh Valley Health Network explained to the station that when a person has very low body temperature, it can preserve the brain and other organ functions. 
 
 Justin, who is now working on his college degree, returned to the hospital with his family on Monday to thank the medical team. 
 
 "It's like I woke up from a dream, but it wasn't a dream, you know," he said. 
 
 "Things happen for a reason," Coleman said as he reunited with his "miracle" patient. "This just kind of renewed the faith of why I do what I do every day." ||||| Extracorporeal membrane oxygenation (ECMO) is a treatment that uses a pump to circulate blood through an artificial lung back into the bloodstream of a very ill baby. This system provides heart-lung bypass support outside of the baby's body. It may help support a child who is awaiting a heart or lung transplant. 
 
 WHY IS ECMO USED? 
 
 ECMO is used in infants who are sick due to breathing or heart problems. The purpose of ECMO is to provide enough oxygen to the baby while allowing time for the lungs and heart to rest or heal. 
 
 The most common conditions that may require ECMO are: 
 
 Congenital diaphragmatic hernia (CDH) 
 
 Heart malformations 
 
 Meconium aspiration syndrome (MAS) 
 
 Severe pneumonia 
 
 Severe air leak problems 
 
 Severe pulmonary hypertension 
 
 It may also be used during the recovery period after heart surgery. 
 
 HOW IS A BABY PLACED ON ECMO? 
 
 Starting ECMO requires a large team of caregivers to stabilize the baby, as well as the careful set-up and priming of the ECMO pump with fluid and blood. Surgery is performed to attach the ECMO pump to the baby through catheters that are placed into large blood vessels in the baby's neck or groin. 
 
 WHAT ARE THE RISKS OF ECMO? 
 
 Because babies who are considered for ECMO are already very sick, they are at high risk for long-term problems, including death. Once the baby is placed on ECMO, additional risks include: 
 
 Bleeding 
 
 Blood clot formation 
 
 Infection 
 
 Transfusion problems 
 
 Rarely, the pump can have mechanical problems (tube breaks, pump stops), which can harm the baby. 
 
 However, most babies who need ECMO would probably die if it were not used.
– When Don Smith found his son, Justin, lying in a McAdoo, Pa., snowbank on Feb. 21, 2015, after Justin had tried to walk home from a bar the night before, it was a terrible sight. "I remember holding him," the elder Smith said in tears Monday, per the Morning Call. "He was like a block of concrete." Don says his son wasn't breathing, lacked a pulse, and had limbs turned black from the cold. Doctors surmise Justin had slipped, hit his head, and blacked out, per CBS News, and he spent about 12 hours in the snow on a night that dipped to minus 4 degrees. Although ABC News says paramedics tried to revive Justin with CPR, the Morning Call notes a coroner was called and a sheet drawn over the Penn State student's head. But an ER doctor at Lehigh Valley Health Network didn't give up: He persuaded doctors to try a life-saving procedure—and thanks to that procedure, Justin, 26, was on hand with his family Monday to thank those doctors for saving his life. That procedure is called extracorporeal membrane oxygenation, and it involves taking blood out of a person's body, warming it and pumping it with oxygen, then putting it back in. Dr. James Wu, the surgeon who did the procedure, says the freezing temps actually helped Justin. "Very low temperatures … can preserve the brain and other organ functions," he said at the news conference, per ABC. It took Justin 15 days to come out of his coma, per CBS, and he lost his toes and pinkies to frostbite, but he suffered no apparent brain damage. Dr. Gerald Coleman, the doctor who made the initial call to try the procedure, is thankful he did. "This case has taught me that sometimes you have to go with your gut, even when all logic demands otherwise," he said, per the Morning Call. As for Justin, he's trying to finish up his psych degree via online courses and his friends have a new nickname for him: Iceman. (A similar miracle out of Norway, where a woman's body temp dropped to 56.7 degrees.)