Der Lawinennotfall

Abstract

In North America and Europe around 140 persons die every year due to avalanches, approximately 35 in North America, 100 in the European Alps, and 5 in other parts of Europe. Most of the victims are skiers and snowboarders. This article outlines the specific pathophysiology of avalanche burials, such as hypoxia, hypercapnia, and hypothermia and also other factors which influence survival. Strategies to minimize the mortality due to avalanches and the on-site treatment of buried persons are discussed. Finally, possibilities to reduce the number of avalanche deaths are pointed out.

Equipment to prevent, diagnose, and treat hypothermia: a survey of Norwegian pre-hospital services

“…Outside the hospital, it is almost impossible to deliver fluid to patients at near body temperature without specially designed equipment. In most cases, giving intravenous fluids with the intention to re-warm the patient will therefore be counterproductive [25,26]. Heated storage cabinets were reported to be available in almost all AS (91%), HEMS (92%), and SAR units (100%).…”

Basic Life Support Ventilation in Mountain Rescue

“…In mountain rescue, cardiopulmonary resuscitation sometimes has to be initiated by BLS-trained mountain rescuers in terrain that is difficult to access and continued for a prolonged period until an ALS-team arrives and intubates the patient. In contrast to the urban setting, mountain rescue scenarios involving deeply hypothermic, avalanche burial (Locher and Walpoth, 1996;Brugger and Durrer, 2002;Paal et al, 2006a) or cold-water immersion patients (Gilbert et al, 2000) may require prolonged cardiopulmonary resuscitation. In these special circumstances, the prognosis remains good (Eich et al, 2005;Lienhart et al, 2005), but prolonged and efficient BLS is necessary to guarantee sufficient organ oxygenation until the patient is rewarmed (Mair et al, 1994;Walpoth et al, 1997).…”

Abstracts from the 3rd Innsbruck Targeted Temperature Management Symposium–A Multidisciplinary ConferenceSeptember 21, 2013Vienna, Austria

“…Also, the potential confounding effects of decompression surgery or pharmacological treatments also complicated the interpretation of these findings (5). More recently, the use of more moderate levels of prolonged systemic hypothermia has been tested in the various experimental settings (6)(7)(8)(9)(10). Thus, a number of research groups have reported the beneficial effects of systemic hypothermia in multiple animal models of SCI including compression and contusive injury.…”

“…The implementation and execution of TTM is interdisciplinary in many different ways; either from a temporal aspect, where TTM is maybe initiated already in the pre-hospital arena and then has to be further performed in the emergency department (ED) and intensive care unit (ICU) [6][7][8]. Here the continuous appliance to a TTM protocol and exact temperature measurements would be important to assure that no rewarming or overcooling during the individual transfers between each receiving ED and ICU can occur [9][10][11].…”

“…If TTM is not started during cardiac arrest, the next possible time is to do so immediately after cardiac arrest. Although current randomized studies comparing pre-to in-hospital initiation of TTM have failed to show an improvement of outcome [6][7][8], animal data…”