Abstract
BackgroundAvalanche emergency response should address current accident scenarios to optimize survival chances of victims and to keep rescuers safe. The purpose of this article is to present a basis for evaluation and necessary adjustments in dispatch, prioritization, and management of Norwegian avalanche rescue operations.MethodsThis is the first peer-reviewed retrospective study of all Norwegian avalanche incidents registered by the two Joint Rescue Co-ordination Centers (JRCCs) in the period 1996–2017 that describes the characteristics and trends of rescue missions and victims.ResultsThe Norwegian JRCCs have registered 720 snow avalanche events, with a total of 568 avalanche victims, of which 120 (21%) died. Including those fatally injured, a total of 313 avalanche victims in 209 accidents were treated as patients (55%), and we saw > 1 patient in 24% of these operations. Norwegian avalanche victims were partially or completely recovered prior to the arrival of rescuers in 75% (n = 117) of all rescue operations. In the remaining 25% of cases, the rescue service located 62% (n = 55) of the avalanche victims visually or electronically. In 50% of the 720 incidents, rescuers spent time searching in avalanches with no victims.ConclusionsThis survey indicates that we have experienced a shift in Norwegian avalanche rescue: from search for missing persons in the avalanche debris to immediate medical care of already-located patients. The findings suggest that a stronger focus on both patient and rescuer safety is necessary. The patients must be ensured the right treatment at the right place at the right time and the allocation of rescue resources must reflect a need to reduce exposure in avalanche terrain, especially in cases with no affirmed victims. We present a flowchart with a recommended rescue response to avalanche accidents in Norway.
Highlights
Avalanche emergency response should address current accident scenarios to optimize survival chances of victims and to keep rescuers safe
The main aim is safe and efficient rescue efforts and the rescue service work to ensure that avalanche victims receive as early and advanced emergency medical treatment as other patients in the country [2, 3]
The existing guidelines state that rescue dogs and volunteer rescue specialists be summoned and dispatched along with the first responding National Air Ambulance Service (NAAS) [4]. This routine normally causes a delay in air rescue response because the specialized resources are not stationed at the helicopter base
Summary
The existing guidelines state that rescue dogs and volunteer rescue specialists be summoned and dispatched along with the first responding National Air Ambulance Service (NAAS) [4]. This routine normally causes a delay in air rescue response because the specialized resources are not stationed at the helicopter base. Asphyxia is the main cause of death in avalanche victims, several studies underline that many victims die because of mechanical injuries [7,8,9], especially to the chest and head This is the case for patients who are not totally buried [7, 10, 11]. Avalanche rescue methodology, which was formerly a domain of the volunteer rescue organizations, is a part of standard operating procedures for all actors in the rescue service [1] and Helicopter Emergency Medical Service
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