Avalanche accidents involving injured patients are a rare type of mission (0.5% of Rega’s primary missions). Around 30% of avalanche victims are in cardiac arrest. Resuscitation of an avalanche victim involves several very specific aspects. Medical care has to be provided in a difficult environment (slope, snow, noise) and under considerable time pressure.
The Avalanche Victim Resuscitation Checklist (AVRC) is a tool that serves to help when making decisions and documenting the medical care provided to avalanche victims in cardiac arrest. It was introduced in Switzerland in the winter of 2014/2015. A new, improved version was developed as part of the new recommendations of the Medical Commission of the International Commission of Alpine Rescue (ICAR MEDCOM) in 2023. Two emergency physicians at Lausanne University Hospital and Rega played a key role in drawing up these recommendations.
A study published in the scientific journal “Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine” shows that the introduction of this checklist resulted in significant improvements to the medical care provided for avalanche victims. Indeed, it offers a standardised approach for stressful and rare situations that rescuers have to cope with, which facilitates rational decision-making.
Moreover, the study advocates more widespread adoption of this checklist by rescue organisations so as to further improve compliance with the recommendations when assisting avalanche victims in cardiac arrest.
Analysis of 87 cases
Between 2010 and 2020, Rega came to the aid of 322 avalanche victims, of whom 96 were in cardiac arrest. The study dealt with the medical care provided to 87 victims, 90% of whom were men. The average age of the group was 42.
The study conducted a retrospective analysis of the medical care provided in these cases and states that “use of the checklist for resuscitation of avalanche victims greatly increased the rate of appropriate care for avalanche victims in cardiac arrest from approximately 60% to 95%. It also ensures comprehensive documentation of the information specific to this type of mission and necessary for the medical care of avalanche victims”.
A race against the Clock
In an avalanche accident, every minute counts. The chance of survival for persons buried under the snow diminishes drastically after 10 minutes, from around 90% after 10 minutes to only around 30% after 30 minutes. This is why help provided by companions on site and an efficient rescue chain are essential.
A recent study also shows that victims assisted by their companions have three times a greater chance of survival than without such aid. The study also reveals a positive effect of the equipment used in avalanche accidents (avalanche transceivers, shovels, probes) on the survival rate.