Wilderness Medical Society Clinical Practice Guidelines for Prevention and Management of Avalanche and Nonavalanche Snow Burial Accidents: 2024 Update.

To provide guidance to the general public, clinicians, and avalanche professionals about best practices, the Wilderness Medical Society convened an expert panel to revise the evidence-based guidelines for the prevention, rescue, and resuscitation of avalanche and nonavalanche snow burial victims. The original panel authored the Wilderness Medical Society Practice Guidelines for Prevention and Management of Avalanche and Nonavalanche Snow Burial Accidents in 2017. A second panel was convened to update these guidelines and make recommendations based on quality of supporting evidence.

Cause of Death in Utah Avalanche Fatalities, 2006-2007 through 2017-2018 Winter Seasons.

INTRODUCTION: Understanding patterns of avalanche fatalities can aid prevention and rescue strategies. In 2007, we published a report reviewing avalanche deaths in Utah between the 1989-1990 and 2005-2006 winter seasons. In the current report, we discuss Utah avalanche fatalities from the 2006-2007 to 2017-2018 seasons. METHODS: Avalanche fatality data were obtained from the Utah Avalanche Center and Utah State Office of the Medical Examiner. Autopsy reports were reviewed to determine demographic information, type of autopsy (external vs internal), injuries, and cause of death. RESULTS: Thirty-two avalanche deaths occurred in Utah during the study period. The mean (±SD) age of victims was 32±13 (8-54) y. Thirty victims (94%) were male and 2 (6%) were female. Seventy-two percent of deaths were from asphyxiation, 19% from trauma alone, and 9% from a combination of asphyxiation and trauma. Snowmobilers accounted for the largest percentage of avalanche fatalities (15 victims; 47%) during the 2007-2018 period. CONCLUSIONS: Asphyxia continues to be the most prevalent killer in avalanche burial. Patterns of ongoing avalanche deaths continue to suggest that rapid recovery and techniques that prolong survival while buried may decrease fatality rates. Trauma is a significant factor in many avalanche fatalities. Education and technologies focused on reducing traumatic injuries such as improved education in techniques for avalanche risk avoidance and/or use of avalanche airbags may further decrease fatality rates. Snowmobilers represent an increasing percentage of Utah avalanche deaths and now make up the majority of victims; increased education targeting this demographic in the basics of avalanche rescue gear and avalanche rescue may also reduce fatalities.

Wilderness Medical Society Practice Guidelines for Prevention and Management of Avalanche and Nonavalanche Snow Burial Accidents.

To provide guidance to clinicians and avalanche professionals about best practices, the Wilderness Medical Society convened an expert panel to develop evidence-based guidelines for the prevention, rescue, and medical management of avalanche and nonavalanche snow burial victims. Recommendations are graded on the basis of quality of supporting evidence according to the classification scheme of the American College of Chest Physicians.

Cause of death in avalanche fatalities.

OBJECTIVE: Avalanches pose a life-threatening risk to participants of outdoor winter activities. Determining the causes of death in avalanche fatalities can aid rescue and resuscitation strategies and hopefully improve survival. METHODS: The study population included all avalanche fatalities in Utah from the 1989-90 to 2005-06 winter seasons. The Utah Avalanche Center and Medical Examiner records were reviewed to identify accident circumstances, autopsy findings, and causes of death. RESULTS: Fifty-six avalanche deaths were identified during the study period. Most deaths occurred while participating in recreational backcountry activities; 85.7% of deaths were due to asphyxiation, 8.9% were due to a combination of asphyxiation and trauma, and 5.4% were due to trauma alone. Head injuries were frequent in those killed solely by trauma. CONCLUSIONS: Most avalanche deaths in Utah result from asphyxia. Therefore, most victims are alive in the postavalanche period and have the potential for live recovery. Rescue strategies that employ rapid recovery as well as techniques that prolong survival while buried provide the best means of improving outcome.