GĂźnther Sumann, Her mann Br ugger
N eu e s a u s d e r L a w i n e nmedizin – Ăœb e r b l i c k u n d a k t u e l l e Themen
Avalanche Medicine - Overview and Current Issues
SUMMARY The calculation of the survival function during avalanche burial fifteen years ago was the beginning of scientific work in avalanche medicine. From this survival function we know that survival from total body burial under an avalanche longer than 35 min is only possible with the presence of an air pocket and open airways, and that most avalanche victims die from asphyxia. Following these findings intense efforts were attempted in proper training of mountaineers and rescue personell, and the utmost importance of an immediate extrication by companions for survival of buried people was stressed. Investigations were performed to understand more about the physiology of breathing in air pockets. Additionally to those devices aiming at a rapid extrication of buried people, safety devices were introduced to prevent a total burial of head and thorax and to allow a longer survival when buried under snow. The similar occurrance of hypoxia, hypercapnia and hypothermia (Triple-H-Syndrome) is characteristic for avalanche victims. The speed of cooling may differ quite strongly and is expected to have an influence on the prognosis of the avalanche victims. During the last years more attention was directed on the probability of trauma in avalanche accidents. It was found that in some regions major trauma was more likely to occur in avalanche fatalities than expected. In British Columbia and Alberta the risk of lethal trauma was found to be 24%, mainly accounted to head and thoracic trauma. This may be explained by the much greater access to forested ski terrain than in Europe. New modifications of safety equipment and 241
