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Reyes-Zaragoza MA, D'Agostino EN, Daniel NJ. Avalanche Education Is Associated with Increased Avalanche Safety Practices in the New Hampshire Backcountry. Wilderness Environ Med 2023; 34:457-461. [PMID: 37726194 DOI: 10.1016/j.wem.2023.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Revised: 06/23/2023] [Accepted: 07/03/2023] [Indexed: 09/21/2023]
Abstract
INTRODUCTION Avalanche risk can be mitigated by adhering to certain safety practices. Previous studies of these practices have focused on western United States and European cohorts. We conducted a survey of backcountry users in the White Mountains of New Hampshire to determine local adherence to 5 previously studied avalanche safety practices. We assessed whether participants were carrying transceiver, probe, and shovel (TPS); had formal avalanche education; had awareness of the day's avalanche danger level; had a route plan; and were traveling in a group. METHODS Backcountry users in the White Mountains were directed to an online survey from December 2020 to June 2021. The survey was completed individually and queried demographics and avalanche safety practices. RESULTS A total of 133 users participated. Not all surveyed participants answered all questions. Avalanche training was reported by 87% of users, 86% checked the avalanche forecast prior to recreating, 93% had a travel plan, 87% traveled in a group, and 59% carried TPS. All 3 items were carried by all group members only 48% of the time. Only 28% of users met all 5 safety practices. CONCLUSIONS White Mountains backcountry users are less likely to meet avalanche safety practices than users in previous studies. There is an association between meeting these defined safety practices and formal avalanche education.
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Affiliation(s)
| | - Erin N D'Agostino
- Division of Neurosurgery, University of Vermont Medical Center, Burlington, VT
| | - Nicholas J Daniel
- Department of Emergency Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH
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Avalanche airbag post-burial active deflation - The ability to create an air pocket to delay asphyxiation and prolong survival. Resuscitation 2019; 146:155-160. [PMID: 31812665 DOI: 10.1016/j.resuscitation.2019.11.023] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2019] [Revised: 11/10/2019] [Accepted: 11/21/2019] [Indexed: 11/23/2022]
Abstract
AIM The primary purpose of an avalanche airbag is to prevent burial during an avalanche. Approximately twenty percent of avalanche victims deploying airbags become critically buried, however. One avalanche airbag actively deflates three minutes after deployment, potentially creating an air pocket. Our objective was to evaluate this air pocket and its potential to prevent asphyxiation. METHODS Twelve participants were fitted with an airbag and placed prone on the snow. Participants deployed the airbag and were buried in 1.5 m of snow for 60 min with vital signs including oxygen saturation (SpO2) and end-tidal CO2 (ETCO2) measured every minute. Participants completed a post-burial survey to determine head movement within the air pocket. RESULTS Eleven of the 12 participants (92%) completed 60 min of burial. Preburial baseline SpO2 measurements did not change significantly over burial time (P > 0.05). Preburial baseline ETCO2 measurements increased over the burial time (P < 0.02); only one ETCO2 value was outside of the normal ETCO2 range (35-45 mmHg). Participants reported they could move their head forward 11.2 cm (SD 4.8 cm) and backward 6.6 cm (SD 5.1 cm) with the majority of participants stated that they had enough head movement to separate the oral cavity from opposing snow if necessary. Visual examination during extrication revealed a well-defined air pocket in all burials. CONCLUSION The avalanche airbag under study creates an air pocket that appears to delay asphyxia, which could allow extra time for rescue and improve overall survival of avalanche victims.
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Berlin C, Techel F, Moor BK, Zwahlen M, Hasler RM. Snow avalanche deaths in Switzerland from 1995 to 2014-Results of a nation-wide linkage study. PLoS One 2019; 14:e0225735. [PMID: 31794568 PMCID: PMC6890213 DOI: 10.1371/journal.pone.0225735] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 11/11/2019] [Indexed: 11/23/2022] Open
Abstract
Objectives More than 20 people die each year in snow avalanches in Switzerland. Previous studies have primarily described these victims, but were not population based. We investigated sociodemographic factors for avalanche mortality between 1995 and 2014 in the entire Swiss resident population. Design and methods Within the Swiss National Cohort we ascertained avalanche deaths by anonymous data linkage with the avalanche accident database at the Swiss WSL Institute of Snow and Avalanche Research SLF. We calculated incidence rates, by dividing the number of deaths from avalanches by the number of person-years, and hazard ratios (HRs) for sociodemographic and economic characteristics using Cox proportional hazard models. Results The data linkage yielded 250 deaths from avalanche within the SNC population for the 20 years 1995 to 2014. The median distance between the place of residence and the place of the event (avalanche) was 61.1 km. Male gender, younger age (15–45 years), Swiss nationality, living in the Alpine regions, higher education, living in the highest socioeconomic quintile of neighbourhoods, being single, and living in a household with one or more children were associated with higher avalanche mortality rates. Furthermore, for younger persons (<40 years) the hazard of dying in an avalanche between 2005 and 2014 was significantly lower than in the years 1995 to 2004 (HR = 0.56, 95%-CI: 0.36–0.85). Conclusion Over a 20-year period in Switzerland, higher rates of dying in an avalanche were observed in men, in younger age groups, and persons with tertiary education, living in the highest socioeconomic quintile of neighbourhoods, and living in an Alpine region. For younger persons (<40 years), the hazard declined during the study period.
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Affiliation(s)
- Claudia Berlin
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Frank Techel
- WSL Institute for Snow and Avalanche Research SLF, Davos, Switzerland
- University of Zürich, Department of Geography, Zürich, Switzerland
| | - Beat Kaspar Moor
- Department of Orthopaedic Surgery and Traumatology, Hôpital du Valais, Martigny, Switzerland
| | - Marcel Zwahlen
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Rebecca Maria Hasler
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Department of Emergency Medicine, Inselspital, University Hospital Bern, Bern, Switzerland
- Department of Trauma, University Hospital Zurich, Zurich, Switzerland
- * E-mail:
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Wallner B, Moroder L, Brandt A, Mair P, Erhart S, Bachler M, Putzer G, Turner R, Strapazzon G, Falk M, Brugger H. Extrication Times During Avalanche Companion Rescue: A Randomized Single-Blinded Manikin Study. High Alt Med Biol 2019; 20:245-250. [PMID: 31264903 DOI: 10.1089/ham.2019.0021] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Aims: This study aimed to determine the time needed for one or two companion rescuers to access, extricate, and deliver cardiopulmonary resuscitation (CPR) to a fully buried manikin during a simulated avalanche burial scenario. Materials and Methods: In this randomized, single-blinded study, 18 medical students were required to extricate a manikin manually from a simulated avalanche burial of 1 m in depth, either alone or in teams of two. Each participant performed three consecutive tests with the manikin in three different positions in random order. Results: Median time to first manikin contact was 2.5 minutes, median time to airway access 7.2 minutes, and median time to standard position for CPR 10.1 minutes. Overall, the number of rescuers (one compared to two rescuers, 10.5 minutes vs. 9.3 minutes; p = 0.686) and the burial position of the manikin (10.8 minutes vs. 10.6 minutes vs. 8.8 minutes; p = 0.428) had no influence on extrication times. Preexisting training (6.1 minutes vs. 11.0 minutes p = 0.006) and a learning effect obtained during the experiments (12.4 minutes the first test vs. 9.3 in the third test; p = 0.017) improved all extrication times. Conclusion: It takes an average of 7 minutes after location of a simulated avalanche victim, buried at a depth of 1 m, to free the airway, plus a further 3 minutes to initiate CPR in standard supine position. This is more than two-thirds of the 15 minutes considered necessary for successful companion avalanche rescue. Even minimal training significantly reduced extrication times. These findings emphasize the importance of regular practice in specific extrication techniques that should be part of any training in avalanche companion rescue.
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Affiliation(s)
- Bernd Wallner
- Department of Anaesthesiology and Intensive Care Medicine, University Clinic Innsbruck, Medical University Innsbruck, Innsbruck, Austria.,Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy
| | - Luca Moroder
- Department of Anaesthesiology and Critical Care Medicine, General Hospital Brixen, Brixen, Italy
| | - Anna Brandt
- Department of Anaesthesiology and Intensive Care Medicine, University Clinic Innsbruck, Medical University Innsbruck, Innsbruck, Austria
| | - Peter Mair
- Department of Anaesthesiology and Intensive Care Medicine, University Clinic Innsbruck, Medical University Innsbruck, Innsbruck, Austria
| | - Stefanie Erhart
- Department of Orthopaedics and Traumatology, University Hospital Hall in Tirol, Hall in Tirol, Austria
| | - Mirjam Bachler
- Department of Anaesthesiology and Intensive Care Medicine, University Clinic Innsbruck, Medical University Innsbruck, Innsbruck, Austria
| | - Gabriel Putzer
- Department of Anaesthesiology and Intensive Care Medicine, University Clinic Innsbruck, Medical University Innsbruck, Innsbruck, Austria
| | - Rachel Turner
- Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy
| | - Giacomo Strapazzon
- Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy
| | - Markus Falk
- Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy
| | - Hermann Brugger
- Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy
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Nichols TB, Hawley AC, Smith WR, Wheeler AR, McIntosh SE. Avalanche Safety Practices Among Backcountry Skiers and Snowboarders in Jackson Hole in 2016. Wilderness Environ Med 2018; 29:493-498. [PMID: 30213711 DOI: 10.1016/j.wem.2018.05.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Revised: 04/11/2018] [Accepted: 05/14/2018] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Carrying standard safety gear (beacon, probe, and shovel), planning a route of descent, and recreating with companions can help to mitigate the risk of injury or death resulting from avalanches in the backcountry. The goal of this study was to identify factors associated with performance of these safety practices. METHODS A convenience sample of backcountry skiers and snowboarders was surveyed in 2016 at the backcountry gates of Jackson Hole Mountain Resort. Each participant was surveyed on characteristics including skill level, sex, age, prior avalanche education, and residency in the Jackson Hole area. Safety practices were also measured against avalanche hazard forecasts. Correlations were assessed using Fisher's exact testing. RESULTS A total of 334 participants were surveyed. Factors associated with carrying avalanche safety gear included higher expertise, being a resident of the Jackson Hole area, and prior avalanche education. Factors associated with having a planned route of descent included higher expertise and being a resident of the Jackson Hole area. Factors associated with recreating with companions included younger age and lower expertise. Sex had no association with any of the surveyed safety practices. Participants were less likely to carry avalanche safety gear on low avalanche hazard days. CONCLUSIONS Certain individual characteristics of backcountry skiers and snowboarders are associated with increased frequency of adherence to recommended safety practices. These findings suggest that particular categories of backcountry recreationists may benefit from further avalanche safety education. The results of this study could help direct future educational efforts among backcountry recreationists.
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Affiliation(s)
- Ty B Nichols
- Department of Emergency Medicine, George Washington University Medical Center, Washington, DC and; Division of Emergency Medicine, TeamHealth, West Region, Emergency Professionals of Colorado, Greeley, CO (Dr Nichols)
| | - Alana C Hawley
- Division of Emergency Medicine, McMaster University, Hamilton General Hospital, Hamilton, Ontario (Dr Hawley); Division of Emergency Medicine, University of Utah, Salt Lake City, UT (Drs Hawley, Wheeler, and McIntosh)
| | - William R Smith
- St. John's Medical Center, Jackson, WY (Drs Wheeler and Smith); Division of Emergency Medicine, University of Washington School of Medicine, Seattle, WA (Dr Smith)
| | - Albert R Wheeler
- Division of Emergency Medicine, University of Utah, Salt Lake City, UT (Drs Hawley, Wheeler, and McIntosh); St. John's Medical Center, Jackson, WY (Drs Wheeler and Smith).
| | - Scott E McIntosh
- Division of Emergency Medicine, University of Utah, Salt Lake City, UT (Drs Hawley, Wheeler, and McIntosh)
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Kong HS, Park GH. Development of Rope Connected Life-Saving Equipment for Transferring Numerous People. J Natl Med Assoc 2018; 110:197-202. [PMID: 29580455 DOI: 10.1016/j.jnma.2017.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2017] [Accepted: 05/11/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND This study is focused on a rapid and safe transfer when there are many people who need rescuing in unapproachable location. Generally, a stretcher, a basket or a mesh drawing is used to transfer injured people or survivors in the emergency rescue, however, it turned out that it takes long time to transfer a number of people with a stretcher and it is difficult to transfer injured people safely with a basket or a mesh drawing. It would expect to transfer many people who need rescuing promptly and harmlessly. METHODS In this article, Targeted Acceptable Responses to Generated Events of Tasks (TARGETS), an event-based team performance measurement methodology was used to investigate the effects of Mission Oriented Protective Posture (MOPP) on the behavioral processes underlying team performance during simulated rescue tasks while wearing chemical protective equipment. In addition, this study determined which team processes were related to team performance outcomes. Results of six primary analyses indicated that team process performance was not degraded by MOPP 4 on any rescue task and that the team processes critical for successful task performance are task-dependent. RESULTS As a result, authors have developed a new life-saving equipment. Numerous people who need rescuing can be quickly and safely rescued and transferred to the hospital with it. From a medical point of view, it reduces the risk of secondary damage from transport and helps avoid missing the golden time for first aid caused by delay in transferring emergency patients as numerous people can be transferred safely and quickly. CONCLUSION The article is due to introduce the equipment which can transfer people who need rescuing promptly and effectively in a situation such as when numerous people need rescuing in the mountain. In a rescue situation such as mountain rescue, rope connected life-saving equipment is dropped to the rescue site with a rope from a rescue helicopter and laying down the injured on the life-saving equipment body and equip life-saving equipment to the rope consecutively. In this way, it is expected to transfer the injured rapidly and safely.
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Affiliation(s)
- Ha-Sung Kong
- Department of Fire Safety, Kyungil University, 50 Gamasilgil, Hayangup, Gyeongsan, Gyeongbuk 38428, South Korea.
| | - Gap-Hwan Park
- Hanil Luchem, 318-2 Bonsanli, Jinyoungeub, Gimhaesi, Gyeongnam 50857, South Korea
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Grasegger K, Strapazzon G, Procter E, Brugger H, Soteras I. Avalanche Survival After Rescue With the RECCO Rescue System: A Case Report. Wilderness Environ Med 2016; 27:282-6. [DOI: 10.1016/j.wem.2016.02.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Revised: 02/09/2016] [Accepted: 02/11/2016] [Indexed: 10/21/2022]
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