Hope for the best; prepare for the worst.
Winter in the Wasatch which means it’s time to discuss avalanche safety. It’s important to understand the risks associated with traveling in avalanche terrain and crucial to know what to do immediately following an avalanche burial. We will begin by covering the dangers of avalanches before providing actionable first aid and rescue information.
Prevention and Preparation
Utah is home to a very robust avalanche forecast center (Utah Avalanche Center) that creates daily predictive models of avalanche hazards based on field and weather observations. It’s always a good idea to check the avalanche forecast the morning before you head into avalanche terrain and steer clear of avalanche dangers. Their are five levels of avalanche danger, ranging from low to extreme. The middle, “considerable” avalanche rating (orange), is the rating where most avalanche fatalities occur.
It’s estimated that roughly 50% of those who travel into avalanche terrain do not carry the basic equipment to perform a hasty avalanche rescue: an avalanche transceiver, a collapsible snow shovel, and an avalanche probe pole. Carrying this equipment can make all the difference if you find yourself in a worst-case scenario. Ensuring that your whole party is similarly prepared is equally important, as an avalanche victim’s greatest chance of survival is when a hasty rescue is performed by their companions. Waiting for rescue is often not an option because the window of survival closes dramatically after 20 minutes of burial, and outside rescue often takes more than 30 minutes to arrive at the scene of an avalanche.
Causes of Death
Naturally occurring avalanches rarely cause accidents and rarely strike without any warning signs. The vast majority of avalanche accidents occur when the victim or someone in the victim’s party triggers the avalanche. Victims of an avalanche can either be partially or completely buried. If the victim’s head and neck are above the snow when the avalanche stops, they are considered to be partially buried and have a 95% chance of survival. Completely buried victims who have their head and neck below the snow, however, only have a 50% chance of survival.
There are three ways to perish in an avalanche: asphyxiation, trauma, and/or hypothermia.
1 // Asphyxiation
Asphyxiation is an insufficient oxygen supply to the body, arising from rebreathing expired air or physical blockage of airway. Asphyxiation accounts for roughly 75% of all avalanche deaths and occurs within the first 15 to 20 minutes of burial, depending on the size of the air pocket present around the victim’s head. Because asphyxiation is the most common cause of death, the majority of completely buried avalanche victims will be alive after the avalanche stops. This means there is a high potential to save an avalanche victim’s life if a timely companion rescue is performed.
2 // Trauma
Trauma is the cause of death for 25% of avalanche victims. Trauma is common to the head, neck, chest, arms, and legs. Trauma to the head and chest can hasten asphyxiation. Traumatic injuries can also cause death instantly or within the first 20 minutes of burial due to complications arising from the traumatic injuries or a combination of trauma and asphyxiation.
3 // Hypothermia
Hypothermia is extremely rare in avalanche victims accounting for less than 1% of all avalanche deaths worldwide. In Utah, hypothermia has not been recorded as a cause of death and is generally not considered a major cause of death in avalanche victims.
First Aid Strategies
First aid strategies revolve around a quick and timely companion rescue. Once the victim is located, every effort should be made to find their head and clear any snow away from their mouth and nose.
After the victim is found, a basic medical assessment should be performed, which involves checking the victim for major and minor injuries in a systematic way. The best approach is to remember A-B-C-D-E. This stands for Airway-Breathing-Circulation-Disability-Exposure.
Below, you’ll find things to look for during the A-B-C-D-E patient assessment, along with some basic first aid tips; however, this is not a replacement for proper hands-on instructions for the listed techniques.
A // Airway
After the victim’s mouth and nose have been uncovered from the snow, it is important to assess the victim’s airway. Check to see if the victim is awake and/or conscious. Ask the victim if they are okay. If they respond, you know they are breathing. If they do not respond, open their mouth and look to see if there is any snow, ice, or debris that may be blocking their airway. If you see any physical blockage, do your best to remove the material with your finger, being careful not to push debris deeper into their throat.
B // Breathing
After clearing the victim’s airway, assess whether the victim is breathing. The quickest and best approach is to “look, listen, and feel” for breathing. Look for signs of breathing: can you see breaths in the cold air environment, or can you see their chest rise and fall with every breath? Listen for signs of breathing. Get your ear as close to the victim’s nose and mouth and listen for any sounds of breathing. Feel for signs of breathing by feeling for warm air on your ears as you listen for breath sounds. You can also check to see if the chest is rising and falling with every breath by placing the palm of your hand on the victim’s chest.
If you don’t see, hear, or feel breath sounds, you’ll want to give the victim three rounds of rescue breaths: breathe in the victim’s mouth for two seconds, remove your mouth from the victim’s, pause for five seconds, then repeat two more times. If at any time the victim begins to breathe or starts coughing, you can cease rescue breaths.
C // Circulation
If the victim does not start breathing after having cleared their airway, chest compressions should be started. If the victim is breathing (before or after giving rescue breaths), lightly check for a pulse for 60 seconds on the carotid artery. This is located just under the angle of the jaw to the left or right of the windpipe.
D // Disability
Disability means the rescuer should be mindful of any major injury to the head, neck, or spine. All attempts should be made to protect the cervical spine (the neck) so that any sudden and extreme movements of the head are limited as much as possible. If the victim is conscious, tell them to limit movements of the neck as much as possible, especially if there are any painful movements. Victims with a suspected head, neck, or spinal injury should be evacuated with the help of search and rescue and/or a helicopter (if possible).
E // Exposure
Once the victim is recovered from the burial, all efforts should be made to keep the victim warm. Give the victim warm puffy jackets, hats, gloves, etc. Protect from wind and get them off the snow by making a bed of empty packs. Hypothermia becomes a major concern for victims of avalanche post-burial and recovery and may make any traumas worse. If the victim is conscious and fully alert (they remember who they are, where they are, what happened, and the day of the week), give them food and/or a warm drink to replenish sugar supplies, which will help keep the victim warm.
Calling for Help
When to call for help is very dependent on the situation; however, outside help should be contacted as soon as reasonably possible. It should be noted that most outside rescues take longer than 30 minutes, during which time the victim has a high chance of perishing from asphyxiation. The best chance for someone surviving an avalanche lies in the hands of people in the direct vicinity of the avalanche, which is usually those traveling in the same group as the avalanche victim.
In conclusion, the best chance for a victim of a complete avalanche burial to survive is a quick companion rescue. Basic first aid should be rendered on victims and care should be focused on clearing the airway and making sure the victim is breathing due to the high chance of asphyxia in complete burials. It’s a good idea to take some basic courses, including an avalanche awareness and rescue course and a basic first aid course that includes an in-person CPR course, to help you stay safe as you enjoy the winter months in the Wasatch.
To learn more about Mountain Medical Academy’s programming, visit mountainmedicalacademy.com.
