Elsevier

Resuscitation

Volume 31, Issue 1, February 1996, Pages 11-16
Resuscitation

Clinical paper
On-site triage of avalanche victims with asystole by the emergency doctor

https://doi.org/10.1016/0300-9572(95)00913-2Get rights and content

Abstract

Asystole in avalanche victims is generally due to asphyxia and not primarily to hypothermia. Hence, on-site establishment of death by asphyxiation would avoid evacuation risks to the rescue party, as well as high costs of transport to, and treatment at, frequently distant specialist centres in cases with a hopeless prognosis. This paper presents a novel differential diagnostic scheme based on burial duration (critical time 45 min) and core temperature (critical level 32 °C) of the person on extrication, as well as the presence or absence of an air pocket, facilitating on-site identification of asphyxiated victims. When information regarding an air pocket is uncertain in victims buried longer than 45 min, determination of serum potassium (critical level 10 mmol/l) at the nearest hospital becomes an alternative criterion for triage. The proposed guidelines aim to clarify field decision-making for the emergency doctor with respect to discontinuation of resuscitation and limitation of transferral for cardiopulmonary bypass core rewarming to those patients with presumptive reversible hypothermia.

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Cited by (61)

  • Survival probability in avalanche victims with long burial (≥60 min): A retrospective study

    2021, Resuscitation
    Citation Excerpt :

    The SLF has collected data on every reported avalanche accident that has occurred in Switzerland since 1936. The registry includes the following information: date and location of avalanche accident, sex and age of victim, type of burial (complete or partial, where complete burial is defined as the burial of at least the head and chest after the avalanche comes to a standstill), burial duration and burial depth, presence of an air pocket (defined as any space surrounding the mouth and nose), airway patency (obstructed airway being defined as both the mouth and the nose obstructed with compact snow or debris), and survival status (alive or dead).3,10–13 The survival status was attributed at hospital discharge for victims who were transported to a medical facility, or on site for victims not transported.

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