BACKGROUND: Current recommendations for rescue and resuscitation of people buried in avalanches are based on Swiss avalanche survival data. We analyzed Canadian survival patterns and compared them with those from Switzerland. METHODS: We extracted relevant data for survivors and nonsurvivors of complete avalanche burials from Oct. 1, 1980, to Sept. 30, 2005, from Canadian and Swiss databases. We calculated survival curves for Canada with and without trauma-related deaths as well as for different outdoor activities and snow climates. We compared these curves with the Swiss survival curve. RESULTS: A total of 301 people in the Canadian database and 946 in the Swiss database met the inclusion criteria. The overall proportion of people who survived did not differ significantly between the two countries (46.2% [139/301] v. 46.9% [444/946]; p = 0.87). Significant differences were observed between the overall survival curves for the two countries (p = 0.001): compared with the Swiss curve, the Canadian curve showed a quicker drop at the early stages of burial and poorer survival associated with prolonged burial. The probability of survival fell quicker with trauma-related deaths and in denser snow climates. Poorer survival probabilities in the Canadian sample were offset by significantly quicker extrication (median duration of burial 18 minutes v. 35 minutes in the Swiss sample; p < 0.001). INTERPRETATION: Observed differences in avalanche survival curves between the Canadian and Swiss samples were associated with the prevalence of trauma and differences in snow climate. Although avoidance of avalanches remains paramount for survival, the earlier onset of asphyxia, especially in maritime snow climates, emphasizes the importance of prompt extrication, ideally within 10 minutes. Protective devices against trauma and better clinical skills in organized rescue may further improve survival.
BACKGROUND: Current recommendations for rescue and resuscitation of people buried in avalanches are based on Swiss avalanche survival data. We analyzed Canadian survival patterns and compared them with those from Switzerland. METHODS: We extracted relevant data for survivors and nonsurvivors of complete avalanche burials from Oct. 1, 1980, to Sept. 30, 2005, from Canadian and Swiss databases. We calculated survival curves for Canada with and without trauma-related deaths as well as for different outdoor activities and snow climates. We compared these curves with the Swiss survival curve. RESULTS: A total of 301 people in the Canadian database and 946 in the Swiss database met the inclusion criteria. The overall proportion of people who survived did not differ significantly between the two countries (46.2% [139/301] v. 46.9% [444/946]; p = 0.87). Significant differences were observed between the overall survival curves for the two countries (p = 0.001): compared with the Swiss curve, the Canadian curve showed a quicker drop at the early stages of burial and poorer survival associated with prolonged burial. The probability of survival fell quicker with trauma-related deaths and in denser snow climates. Poorer survival probabilities in the Canadian sample were offset by significantly quicker extrication (median duration of burial 18 minutes v. 35 minutes in the Swiss sample; p < 0.001). INTERPRETATION: Observed differences in avalanche survival curves between the Canadian and Swiss samples were associated with the prevalence of trauma and differences in snow climate. Although avoidance of avalanches remains paramount for survival, the earlier onset of asphyxia, especially in maritime snow climates, emphasizes the importance of prompt extrication, ideally within 10 minutes. Protective devices against trauma and better clinical skills in organized rescue may further improve survival.
Authors: Jasmeet Soar; Gavin D Perkins; Gamal Abbas; Annette Alfonzo; Alessandro Barelli; Joost J L M Bierens; Hermann Brugger; Charles D Deakin; Joel Dunning; Marios Georgiou; Anthony J Handley; David J Lockey; Peter Paal; Claudio Sandroni; Karl-Christian Thies; David A Zideman; Jerry P Nolan Journal: Resuscitation Date: 2010-10 Impact factor: 5.262
Authors: Terry L Vanden Hoek; Laurie J Morrison; Michael Shuster; Michael Donnino; Elizabeth Sinz; Eric J Lavonas; Farida M Jeejeebhoy; Andrea Gabrielli Journal: Circulation Date: 2010-11-02 Impact factor: 29.690
Authors: Hermann Brugger; Günther Sumann; Roland Meister; Liselotte Adler-Kastner; Peter Mair; Hanns Christian Gunga; Wolfgang Schobersberger; Markus Falk Journal: Resuscitation Date: 2003-07 Impact factor: 5.262
Authors: H Stalsberg; C Albretsen; M Gilbert; M Kearney; E Moestue; I Nordrum; M Rostrup; A Orbo Journal: Virchows Arch A Pathol Anat Histopathol Date: 1989
Authors: Hermann Brugger; Hans Jürg Etter; Benjamin Zweifel; Peter Mair; Matthias Hohlrieder; John Ellerton; Fidel Elsensohn; Jeff Boyd; Günther Sumann; Markus Falk Journal: Resuscitation Date: 2007-08-06 Impact factor: 5.262
Authors: Giacomo Strapazzon; Peter Paal; Jürg Schweizer; Markus Falk; Benjamin Reuter; Kai Schenk; Hannes Gatterer; Katharina Grasegger; Tomas Dal Cappello; Sandro Malacrida; Lukas Riess; Hermann Brugger Journal: Sci Rep Date: 2017-12-15 Impact factor: 4.379