A new study by Eurac Research and Medical University of Innsbruck focuses on resuscitation practiced by non-experts.
A group of climbers is caught by an avalanche. For the rescue, every minute counts. Now the life or death of those caught in the avalanche depends mainly on their companions, as they are the first to be able to help. But how long does it take to exhume and resuscitate an avalanche victim? In a new study, emergency doctors from Eurac Research and the Medical University of Innsbruck focus, for the first time, on such a scenario. The aim is to develop guidelines for the immediate rescue and resuscitation of avalanche victims, by their companions. To do this, the researchers will review the current standard rescue procedures in order to make them suitable for inexperienced users in future.
Studies previously conducted by Eurac Research have shown that avalanche victims who are rescued by their companions in the first fifteen minutes have a 90% chance of survival. However, to date, it is still unclear how long it takes for one or two inexpert rescuers to free a fellow companion buried under an avalanche snow deposit and to start resuscitation. Another aspect that has not yet been investigated is the position of people caught by an avalanche. In a typical avalanche scenario, more than half of victims are found with their lower body positioned uphill, their head downhill and their mouth and nose also facing downward. For rescue and resuscitation, this is the worst position. In this new study, the emergency mountain doctors of Eurac Research examine how best to proceed with this type of companion rescue, plus whether it is more or less effective if one or two of the victim’s inexpert companions proceed with the attempt.
Currently, the scientific literature recommends digging out the victim’s body and placing the victim in a standardised horizontal position on their back so that cardiac massage and respiration can be performed effectively. It is unknown, however, how long it takes an unskilled person to do this effectively. "We know that resuscitation must start as soon as possible to avoid permanent damage due to lack of oxygen. If conditions allow, respiration and cardiac massage should be carried out without waiting for the entire body to be freed", explains Bernd Wallner, emergency mountain doctor of Eurac Research, whom also works at the Medical University of Innsbruck. "What really interests us is to gain understanding of how, in difficult circumstances, such as when the victim is buried in a critical position, precious minutes can be saved and resuscitation performed effectively."
In the first part of the study, researchers will calculate how long it takes a professional rescuer to completely excavate a person and put him/her in the standard position to start resuscitation. In the subsequent phase, eighteen people will be asked to unearth mannequins that researchers have buried under the snow in different positions. "The eighteen volunteers represent the classic ski-mountaineer who has attended a first aid course and has basic avalanche rescue training," explains Bernd Wallner. The researchers will calculate the times and compare them.
The second part of the study will take place in the clinic. Here the researchers will analyse the quality and effectiveness of different resuscitation techniques, thanks to technologically advanced rescue mannequins which are capable of measuring the effect of the cardiac massage on the basis of different parameters. Parameters of interest focus of the exact CPR technique employed by each participant, such as: at which location, at what depth, speed, and frequency it is performed. Combining all these values, the researchers expect to see whether the chances of survival increase when resuscitation starts as soon as possible, even if the position of the victim is not ideal. The results will be available in the autumn.