Guidelines for Mountain Rescue During the COVID-19 Pandemic: Official Guidelines of the International Commission for Alpine Rescue

Abstract

Roy, Steven, Inigo Soteras, Alison Sheets, Richard Price, Kazue Oshiro, Simon Rauch, Don McPhalen, Maria Antonia Nerin, Giacomo Strapazzon, Myron Allen, Alistair Read, and Peter Paal. Guidelines for mountain rescue during the COVID-19 pandemic: official guidelines of the International Commission for Alpine Rescue. High Alt Med Biol . 22: 128–141, 2021. Background: In mountain rescue, uncertainty exists on the best practice to prevent coronavirus disease 2019 (COVID-19) transmission. The aim of this work was to provide a state-of-the-art overview of the challenges caused by the COVID-19 pandemic in mountain rescue. Methods: Original articles or reviews, published until December 27, 2020 in Cochrane COVID-19 Study Register, EMBASE, PubMed, and Google Scholar were included. Articles were limited to English, French, German, or Spanish with the article topic COVID-19 or other epidemics, addressing transmission, transport, rescue, or cardiopulmonary resuscitation. Results: The literature search yielded 6,190 articles. A total of 952 were duplicates and 5,238 were unique results. After exclusion of duplicates and studies that were not relevant to this work, 249 articles were considered for this work. Finally, 72 articles and other sources were included. Conclusions: Recommendations are provided for protection of the rescuer (including screening, personal protective equipment [PPE], and vaccination), protection of the patient (including general masking if low risk, specific PPE if high risk), equipment hygiene (including disinfection after every mission), use of single-use products, training and medical measures under COVID-19 precautions, and psychological wellbeing of rescuers during the COVID-19 pandemic. Adapted COVID-19 precautions for low-and-medium-income countries are also discussed.

Surgical masks and filtering facepiece class 2 respirators (FFP2) have no major physiological effects at rest and during moderate exercise at 3000-m altitude: a randomised controlled trial

“…With respect to cognitive function and thermal stress, no influence of mask wearing was detected. This study confirms the results obtained during a simulated commercial flight 9 and extends them by increasing both altitude and physical activity levels, with applicability ranging from mountain 3 to aviation 10 scenarios, not only for passengers but also for crew members performing physical or cognitive tasks.…”

“…During the Coronavirus disease 2019 (COVID-19) pandemic, the World Health Organisation as well as various national governments advised citizens to wear face masks in public and at work. 1 The use of filtering facepiece class 2 respirators (FFP2) has been recommended to health workers 2 including mountain rescuers, 3 as well as to other professional groups and in high-risk settings depending on local regulations.…”

Influence of positive end-expiratory pressure on arterial blood pressure in mechanically ventilated trauma patients in the field

“…The no/low and moderate PEEP groups with 0–5 and 5–10 cmH 2 O, respectively, were voluntarily chosen; this was based on clinical and experimental experience of the ability of PEEP to influence hemodynamic stability. 2 However, correlation, that is not based on comparison between different groups, revealed arterial systolic pressure being completely independent from PEEP in this cohort of 296 patients. Further, both groups were different in size which may have the potential to reduce reliability of statistical methods.…”

“…After hospital admission, the patient died in the emergency room due to a rupture of the right subclavian artery with uncontrolled intrathoracic bleeding (unpublished data), which is in accordance with multiple recommendations. 1 2 3 4 ]…”

Adventure travel and the Covid-19 pandemic — recommendation of the Medical Commission of the Union Internationale des Associations d’Alpinisme (UIAA)

“…Access to specialist or generalist's advice for non-covid pathology is likely to be restricted. Outside hospitals rescue services may be impaired by the need for personal protective equipment and the need to change and clean equipment between rescues [15]. On a global scale there are suggestions of changes in disease patterns with the example of faltering efforts in TB control being reported.…”