On-Site Medical Management of Avalanche Victims—A Narrative Review

Rauch, Simon; Strapazzon, Giacomo; Brugger, Hermann

doi:10.3390/ijerph181910234

Cited by 9 publications

(3 citation statements)

References 66 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Patients who do not show vital signs after five rescue breaths need to be resuscitated applying the 30:2 cardio-pulmonary resuscitation protocol [13,19]. If there is no shortage of resources, thus all other buried subjects are currently being excavated or have already received medical treatment, CPR should be applied by BLS-trained rescuers until the patient can be handed over to professional health care providers.…”

Section: Resultsmentioning

confidence: 99%

AvaLife—A New Multi-Disciplinary Approach Supported by Accident and Field Test Data to Optimize Survival Chances in Rescue and First Aid of Avalanche Patients

Genswein¹,

Macias

McIntosh

et al. 2022

IJERPH

View full text Add to dashboard Cite

Snow sports in the backcountry have seen a steep increase in popularity, and therefore preparedness for efficient companion and organized rescue is important. While technical rescue skills are widely taught, there is a lack of knowledge regarding first aid for avalanche patients. The stressful and time-critical situation for first responders requires a rule-based decision support tool. AvaLife has been designed from scratch, applying mathematical and statistical approaches including Monte Carlo simulations. New analysis of retrospective data and large prospective field test datasets were used to develop evidence-based algorithms exclusively for the avalanche rescue environment. AvaLife differs from other algorithms as it is not just a general-purpose CPR algorithm which has been slightly adapted for the avalanche patient. The sequence of actions, inclusion of the ≥150 cm burial depth triage criterion, advice to limit CPR duration for normothermic patients to 6 min in case of multiple burials and shortage of resources, criteria for using recovered subjects as a resource in the ongoing rescue, the adapted definition of “injuries incompatible with life”, reasoning behind the utmost importance of rescue breaths, as well as the updated BLS-iCPR algorithm make AvaLife useful in single and multiple burial rescue. AvaLife is available as a companion rescue basic life support (BLS) version for the recreational user and an advanced companion and organized rescue BLS version for guides, ski patrols and mountain rescuers. AvaLife allows seamless interoperability with advanced life support (ALS) qualified medical personnel arriving on site.

show abstract

Section: Resultsmentioning

confidence: 99%

AvaLife—A New Multi-Disciplinary Approach Supported by Accident and Field Test Data to Optimize Survival Chances in Rescue and First Aid of Avalanche Patients

Genswein¹,

Macias

McIntosh

et al. 2022

IJERPH

View full text Add to dashboard Cite

show abstract

“…In this specific case, the following aspects of treatment would be handled differently according to present-day guidelines 10 : Current guidelines recommend transporting severely hypothermic avalanche victims, who present with a core temperature <30 °C, systolic blood pressure <90 mm Hg, ventricular arrhythmias, or any other cardiac instability, directly to a center offering rewarming with extracorporeal life support (ECLS). 10,14 There, in case of hypothermic cardiac arrest, ECLS rewarming could be initiated with minimal delay. 10,15 In 2000, this treatment had already been established, but no recommendation existed to transfer patients with core temperature <30 °C directly to a center capable of ECLS rewarming. In an ECLS center, a patient with core temperature <30 °C and spontaneous circulation should be rewarmed actively externally (eg, with warmed forced air) and minimally invasively (with warmed infusions, according to volume requirements).…”

Section: Discussionmentioning

confidence: 99%

Surviving 20 Hours of Critical Avalanche Burial and a Core Temperature of 22.5 °C

Wallner,

Lienhart,

Cools

et al. 2023

Wilderness & Environmental Medicine

View full text Add to dashboard Cite

A 24-year-old male snowboarder was buried in an avalanche for 20 h and rescued on the next day at a depth of 2.3 m below the snow surface. A large air pocket was noted in front of his mouth and nose. He was responsive but moved restlessly and uncoordinatedly. The epitympanic temperature was 22.5 °C. He was bradycardic (35/min), and a right bundle branch block with Osborn waves was noted. Rewarming (1 °C/h) was initiated with continuous hemodialysis; core temperature raised to 29.8 °C within 4 h. At 30 °C he became conscious. With rewarming, the heart rate increased to 90 beats per minute and the ECG changes disappeared; nonfreezing cold injuries were noted. On the next day, his pulmonary function deteriorated—fluid overload of 9 L since admission was diagnosed. With spontaneous diuresis, the situation improved. On Day 4, the neurologist reported subtle polyneuropathy in both legs secondary to hypothermia, without tendency to regress. This case occurred more than 20 years ago but has not been reported yet. To this day, this is the third-longest critical avalanche burial ever reported. We discuss the circumstances of this accident, the clinical course, and how treatment has changed since 2000.

show abstract

“…Bei Lawinenverschütteten spielt die Asphyxie eine entscheidende Rolle für den Herz-Kreislauf-Stillstand 17 , 18 . 75 % aller Lawinentoten gehen auf eine Asphyxie zurück 19 , lediglich 25 % sind traumaassoziiert und nur ca. 1 % versterben aufgrund einer Hypothermie.…”

Section: Lawinenrettungunclassified