Urs Wiget
Einige praktische Tipps für die alpine Notfallmedizin in der Kälte Practical hints for rescue doctor’s working in the cold S U M M A RY Very cold field conditions add a lot of problems to the emergency medicine. The doctor’s personal equipment, experience, and fitness decides whether he will be able to perform medical emergency procedures even after waiting in the cold for hours or if he will become an useless member of the rescue squad.As personal equipment, we emphasize special gloves, a personal bagpack with extra clothes and hot tea, snowshoes with ski poles for avalanche rescue and more. Even for the most experienced mountain rescue doctor intense cold may block the intravenous access to a multi – injured patient. If the access to the external jugular vein as last choice is not possible, an intraosseus needle may help.The problem of frozen perfusion liquids can be avoided: give a big amount of fluid in a very short time with pressure on the fluid bag and close the I.V. catheter during transport. To prevent further hypothermia, hot packs, an electrically heated sleeping bag and a tent for treatment may be useful. To imagine and think about all foreseeable problems and to check carefully the equipment before leaving the rescue base may help to be really effective at the spot. Blindly rushing to the scene of the accident is not adequate: the mountain and the cold make the triage of the patients rather than you with some speared minutes in the rush. Keywords: mountain rescue physician, cold, emergency medicine, equipment.
Z U S A M M E N FA S S U N G Große Kälte und Wind erschweren die notfallmedizinische Arbeit des Bergrettungsarztes erheblich. Praktische Erfahrung, eine gute körperliche Leistungsfähigkeit und eine adäquate Ausrüstung erlauben dem Arzt, auch noch nach stundenlangem Ausharren in der Kälte effektiv zu arbei-
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