❙ Hermann Brugger, Fidel Elsensohn, Matthias Hofer, Christian Masoner, Claudio Gecele, Werner Beikircher, Peter Paal ❙
Lawinenmedizin 2016 – ein Update Management of avalanche victims 2016 – an update
SUMMARY Recent publications pertaining to the analysis of avalanche victim treatment and outcome have established a strong inference that an excessive number of asphyxial victims were transported to hospital for extracorporeal rewarming, contrary to the guidelines. Equally, crucial information regarding the physiological status of the victims at extrication was reportedly misplaced, thus precluding the medical hospital staff from correctly following the recommended triage guidelines on admittance. In 2015, the European Resuscitation Council (ERC) updated previous treatment guidelines and published a new algorithm for the on-site management of avalanche victims. The respective cut-off values for prolonged cardiopulmonary resuscitation and subsequent transport of arrested avalanche victims to hospitals with extracorporeal rewarming facilities have been changed; i.e., duration of burial increased from 35 to 60 min, core temperature cut off decreased from 32°C to 30°C and serum potassium levels decreased from 12 to 8 mmol/L. To improve patient data transfer from the avalanche site to emergency department admittance, the International Commission for Mountain Emergency Medicine (ICAR MEDCOM) proposed an avalanche checklist that should be completed by the rescue services on-site and be kept with the patient until hospital admission is complete. In an attempt to optimise prehospital management and decrease mortality of avalanche victims, both the implementation of the updated ERC recommendations and the avalanche checklist should jointly be introduced by respective air rescue, mountain rescue, and emergency medical services. Keywords: avalanche, cardiac arrest, checklist, hypothermia, mountain rescue 11
