Preživetje v primeru snežnih plazov - načini zdravljenja, tehnike samoreševanja in varnostna oprema za smučarje po neoznačenih progah
Considerations on avalanche survival, therapeutic principles, self-rescue techniques and safety equipment for backcountry and off-piste skiers

english

2004

volume 43, issue 3

Snow    Accidents    Survival    Rescue Work   Emergency Medical Services    Time Factors   Anoxia    Hypercapnia    Hypothermia    Cardiopulmonary Resuscitation    therapy 

Društvo Medicinski razgledi
(Obvezni izvod spletne publikacije)

The median annual mortality from snow avalanches registered in the 17 ICAR countries from 1981 to 1998 was 146. Swiss data document a mortality rate of 52.4% in compleiely-buried, versus 42% in partially-, or non-buried, persons (n = 1886). The survival probability of completely-buried victims in open areas (n = 638) plummets from 91% at 18 min after burial to 34% at 35 min (acute asphyxiation of victims without an air pocket), then remains fairly constant until a second drop after 90 min (the "latent phase" for victims withan air pocket). The inflection point of the survival probability curve at 35 min (figure 1) indicates that victims completely buried under an avalanche cannot survive beyond 35 min without an air pocket d prospective, randomised study in volunteers (28 tests) breathing inio an artificial air pocket (11 or 21 volume) in snow showed that peripheral oxygen saturation SpO2 decreased from median 99% to 88% (p < 0.001) within 4 min. End tidal carbon dioxide rosefrom median 38 to 51 mmHg (p < 0.001), with conscquent respiratory acidosis. We conclude that the degree of hypoxia following avalanche burial isdependent on air pocket volume, snow density and unknown individual personalcharacteristics, yet long-term survival is possible with only a small air pocket. The combination of hypoxia, hypercapnia and hypothermia in personsburied by avalanches presenting an air pocket and free airways is designated as "triple H syndrome". Standardised guidelines are introduced for the field management of avalanche victims. Strategy is primarily governed by the Iength of snow burial, the victim's core temperaiure and the presence of an air pocket. With a burial time <= 35 min, survival depends on preventing asphyxia by rapid extrication and immediate airway management, and cardiopulmonary resuscitation for unconscious victims without spontaneous respiration. (Abstract truncated at 2000 characters).

24.06.2015