New avalanche, snow burial practice guidelines from the Wilderness Medical Society

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In continuing to promote avalanche education, Backcountry Access is pleased to share the new white paper: The Wilderness Medical Society Practice Guidelines for Prevention and Management of Avalanche and Nonavalanche Snow Burial Accidents.

In this report, the Wilderness Medical Society (WMS) outlines practice guidelines to help medical professionals, as well as the public, understand the latest techniques and recommendations for avalanche risk management and rescue protocols.  To provide guidance to clinicians and avalanche professionals about best practices, the WMS convened an expert panel to develop evidence-based guidelines for the avalanche prevention, avalanche rescue, and post-avalanche medical management of avalanche victims. The panel focused exclusively on developing evidence-based recommendations for three main aspects of avalanche and snow burial accidents: prevention, rescue, and resuscitation.

The Wilderness Medical Society guidelines concur with BCA’s primary avalanche safety recommendation that avalanche avoidance should be the main method to mitigate risk of injury and death.

If an avalanche incident occurs, companion rescue — including appropriate resuscitation and advanced life support measures — are critically important to reduce avalanche morbidity and mortality.

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This Wilderness Medical Society flowchart shows the decision points and steps to assessing an avalanche victim at the point of extrication.  The WMS defines this as the avalanche accident algorithm for management of completely buried victims. ECLS, extracorporeal life support.

An avalanche accident presents a unique set of challenges for rescue workers – the most important of which is assessing patient condition and signs of asphyxiation and bodily trauma.

  • Asphyxia is the most common cause of mortality in avalanche victims, accounting for 75% of deaths.
  • Trauma is the primary cause of death for approximately 25% of avalanche fatalities.

Asphyxiation can occur via three main mechanisms: inhaled snow or other debris blocks an airway; water vapor from expelled air freezes and forms an ice mask around the face; or oxygen deprivation caused by having to rebreathe expired air. Because of the dangers of asphyxiation, time plays a crucial role in avalanche survival rates. If completely buried, an avalanche victim has a greater than 90% survival rate if they are found and extricated within about 15 minutes, but only a 30% survival rate if the avalanche rescue time stretches to 30 minutes. In addition, many avalanche victims suffer life-threatening injuries during their avalanche involvement.

Traumatic deaths are associated with a wide range of avalanche-induced injuries, which depend on geographic differences in terrain features and snowpack. The proportion of avalanche deaths related to trauma in Canada has been reported to be higher than that in Europe and the United States. Avalanche victims can sustain virtually any type of injury during the often-turbulent descent in an avalanche. Severe injuries are frequently caused by collisions with trees or rocks. Minor injuries likely remain unreported. The most common serious injuries are to the head, cervical spine, chest, and extremities. In an analysis that examined closed head injuries in avalanche victims, evidence of traumatic brain injury was found in the majority of those studied.

Each year, there are over 150 avalanche fatalities in the US and Europe, with most deaths occurring among recreational groups that include skiers, snowboarders, snowmobilers, mountaineers, and snowshoers. Occupational-related avalanche fatalities among ski patrollers, mountain rescuers, mountain guides, and transportation workers occur less frequently, although job requirements may place these personnel at higher and more prolonged risk.

Download the complete white paper here to read and learn more.