Avalanche Preparedness

Winter is here...and in many places it brings snow to the mountains. Lots of it. And with lots of mountain snow comes avalanches. Some of them are fatal.

As a former ski patroller and an avid back country skier, I'm familiar with avalanches. I've watched friends go for rides, recovered bodies, and even been fully buried myself. I have lots of stories. When I was caught and buried we did all the "right" stuff (dug multiple pits, were familiar with the snowpack and terrain, cut the hill numerous times) but none-the-less I got caught. It was a wild and scary ride. I'm quite glad my friend was well trained, had years of rescue experience, and there to dig me out. Although I managed to create a small air hole with my left hand before the snow completely settled, I don't think I could have gotten free by myself. I lost some gear, broke a brand new ski (it could easily have been my leg), and gained increased respect for the power of sliding snow. Later that winter I overheard a ski buddy with years of ski guiding, patrolling, and avy control experience say to a new backcountry skier: "If you spend enough time skiing in the high mountains, you'll eventually get caught in a sluff or avalanche." Whoa! Not particularly reassuring, yet I've found it to be true....

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That said, you can decrease your chances of getting caught and increase your chances of survival if you:

• take an avalanche course, maintain your skills, and practice what you learn
• travel with others who are trained in avalanche awareness, rescue, and wilderness medicine
• turn on your avalanche transceiver before you enter avalanche terrain
• In areas where SAR use RECCO® dectectors (radar technology), consider wearing one or more RECCO® reflectors
• have communication via cell or satellite phone with SAR
• buy, practice with, and wear an AvaLung, pack air bags, or similar device
• listen to the local avalanche forecast and making prudent decisions

Here are a number of web sites that offer avalanche information and education:

• Utah Avalanche Center online tutorials
• Online portal to all major US forecast centers
• Online portal to all Canadian forecasts and education
• Avalanche basics from the Forest Service National Avalanche Center
• A "must see" move about five friends, the decisions they made, and a fatal avalanche: "A Dozen More Turns"

Treatment Guidelines for Avalanche Victims
Background & Pathophysiology
Roughly 65% of victims who perish in an avalanche die from a lack of oxygen (hypoxia); 15% from a combination of hypoxia, high levels of carbon dioxide (hypercapnia), and hypothermia; and, 20% die from traumatic injuries. Several factors determine the victim’s ultimate chances of survival, including burial time, presence and size of an air pockets, the density of the snow, and the severity of any traumatic injuries. According to current research, there is a 91% probability of survival if the victim is recovered within 18 minutes; this is called the survival phase. The chance of survival drops to 34% over the next 22 minutes during the asphyxia phase, drops again to 28% between 35-90 minutes, and even further to 7% between 90-120 minutes. In the asphyxia phase, all persons without an air pocket die. Hypothermia and hypercapnia are only concerns with complete burials exceeding 90 minutes. NOTE: While rare, patients having a large air pocket or access to outside air have survived up to two hours.
Once the victim has been located, take care to preserve any air pocket by digging diagonally from downhill rather than vertically along the probe. Clear the patient’s mouth and nose ASAP to establish an open airway. The presence of an air pocket and no snow in the patient’s airway indicate that the victim was still breathing after the avalanche. Most air pockets are small and sickle-shaped, with ice on the inner surface of the pocket next to the patient’s mouth and nose. In complete burials exceeding 35 minutes, the patient may be moderately to severely hypothermic. Excavate a large hole, move the victim as little and as slowly as possible, and place them in a hypothermia package. Warming and resuscitation efforts, if necessary, should occur concurrently.

Specific BLS Resuscitation Guidelines

• If a patient is not breathing, has no signs of circulation after a 60-second pulse check, and burial time is known or estimated to be less than 20 minutes, begin CPR (not CCR). If an AED is available, follow the guidelines for a normothermic patient. If a pulse does not return within 30 minutes, STOP CPR.
• If an air pocket is present or uncertain, the patient is not breathing, has no signs of circulation after a 60-second pulse check, and burial time is estimated to be between 18-35 minutes, BEGIN CPR. If an AED is available, follow the guidelines for a hypothermic patient. If a pulse does not return with 30 minutes, STOP CPR.
• Stop Resuscitation Efforts if there has been a documented 30 minutes of pulselessness; the patient is dead.
• If there is NO air pocket, the patient is not breathing, has no signs of circulation after a 60-second pulse check, has snow in their mouth and/or nose, and burial time is estimated to be greater than 35 minutes, DO NOT START CPR; the victim is dead.

Want more information on this and other wilderness medicine topics? Take one of our wilderness medicine courses. Guides and expedition leaders should consider taking our Wilderness First Responder course.

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