Avalanche Safety Practices in Utah

We are finally in the midst of repeated major snowfalls in the Sierra of northern California. Given the large accumulations here and in other mountain ranges, such as the Wasatch Range of Utah, avalanches are inevitable. One may not head for the slopes at a ski resort thinking about avalanche hazard, but it is wise to do so. This is highlighted in an article that appears in the 4th issue of Volume 18 of the journal Wilderness & Environmental Medicine, which has recently been published.

Natalie Silverton, M.D. and her colleagues from the Division of Emergency Medicine at the University of Utah commented in an article entitled "Avalanche Safety Practices in Utah." They utilized a survey of 353 winter backcountry users to determine the percentage of participants in a variety of categories with respect to whether they were carrying avalanche transceivers, shovels, probes, or AvaLungs; whether or not they had taken an avalanche safety course; and whether they were traveling solo or with a partner(s). Interviewees were backcountry skiers, snowboarders, snowshoers, snowmobilers, and out-of-bounds resort skiers/snowboarders traveling in the Wasatch and Uinta Mountains of Utah during the winter of 2005-06.

The results are revealing and make sense. Backcountry skiers showed the highest level of avalanche preparedness, with 98% carrying avalanche transceivers, 98% carrying shovels, 77% carrying probes, 86% having taken an avalanche safety course, and 88% carrying out minimum safety practices. Out-of-bounds snowboarders were the least prepared, with only 9% carrying avalanche transceivers, 9% carrying shovels, 7% carrying probes, 33% having taken an avalanche safety course, and 2% carrying out minimum safety practices. The authors concluded, "There are significant differences in the avalanche safety practices of backcountry travelers in Utah. Backcountry skiers and snowboarders were the most prepared, while snowmobilers, snowshoers, and out-of-bounds skiers/snowboarders were relatively less prepared."

Unless the demographics and attitudes of the respondents for this survey are remarkably different from those of similar populations that utilize the winter backcountry, this very useful demonstration points us in the direction of where best to apply outdoor safety education campaigns. If snowmobilers, snowshoers, and out-of-bounds skiers/snowboarders are least well prepared to survive an avalanche, if they can be persuaded to be better prepared, that might result in fewer future personal tragedies.

"Fresh Frosting, Wasatch Mountains, Utah" by David Whitten at www.davidwhittenphoto.com

Tags: avalanche safety,avalanche, Utah, wilderness medicine, outdoor medicine, healthline

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Cause of Death in Avalanche Fatalities

There are many excellent and informative articles in the 4th issue of Volume 18 of the journal Wilderness & Environmental Medicine. One that is particularly interesting is entitled, "Causes of Death in Avalanche Victims."

Scott McIntosh, M.D. and his co-authors from the University of Utah in Salt Lake City reviewed records from the Utah Avalanche Center and the medical examiner that covered the time period from the 1989-90 to 2005-06 winter seasons. The records were reviewed to identify accident circumstances, autopsy findings, and causes of death.

From reviewing 46 avalanche deaths, it was determined that 85.7% of deaths were due to asphyxiation, 8.9% were due to a combination of asphyxiation and injuries (trauma), and 5.4% were due to injuries alone. Head injuries were common in persons killed solely by injuries.

The conclusion was straightforward and has been corroborated often anecdotally by avalanche rescue experts - namely, that avalanche deaths (in this case, in Utah) result from asphyxia (suffocation leading to lack of oxygen in the brain and body). Therefore, most victims are alive for a period of time in the post-avalanche period and have the potential for live recovery until they succumb to asphyxia. According to the authors, rescue strategies that employ rapid recovery as well as techniques that prolong survival while a person is buried provide the best means for improving outcomes.

Colin Grissom, M.D. (a good friend, the President-elect of the Wilderness Medical Society, and a co-author on the article discussed in this particular post) and I discussed this a bit last October in Aviemore, Scotland at the WMS-ISMM World Congress. Based on our discussion, I have initiated a project to evaluate the practicality of design of a novel avalanche survival device. It is not an easy project, but one worthy of effort, given the dismal fate of most persons who become entombed in the unyielding snow that smothers them within the debris of an avalanche. We are not yet close to success, but we are still at it.

photo courtesy of Richard L. Armstrong

Tags: avalanche safety ,death, asphyxiation, avalanche, wilderness medicine, outdoor medicine, healthline

Labels: asphyxiation, avalanche

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2008 Wilderness & Mountain Medicine Conference

It always gives me great pleasure to announce the continuing medical education (CME) meetings sponsored by the Wilderness Medical Society. The next great event is the 2008 Wilderness & Mountain Medicine Conference, which will be held at The Canyons Resort in Park City, Utah from February 23-27, 2008. Registration for the meeting is available at the WMS website.

Following the theme of last year's successful winter meeting, this event will emphasize issues related to winter environments and activities. There will be a pre-conference Level 1 Avalanche Course, taught by Exum Utah Mountain Adventure guides, Utah Avalanche Center, The Canyons Ski Patrol, and WMS faculty. This is both a didactic and hands-on program designed to allow the participants to learn about safe travel in avalanche terrain, avalanche transceiver use, and snowpack analysis. They will practice efficient rescues with avalanche beacons, and study avalanche victim physiology and medical treatment. This is a certificate program, so that after completion, the participants will be recognized by the American Avalanche Association. There will also be a post-conference Advanced Wilderness Life Support Certification Course.

One of the strongest features of the WMS programs is delivery of optional workshops, which for this meeting will include Introduction to Backcountry Touring, Avalanche Awareness on Snowshoes or Skis, Snowmobile Safety, Ski Patrol Trauma Evaluation, Improvised Splinting, Litters and Packaging, Snowshelters, and Snowshoeing.

The special evening presentations look spectacular. Attendees and guests will be entertained by Andrew McLean on "Extreme Skiing," Dr. Luanne Freer on "What's Your Everest? Combining Your Profession With Your Passion," Dr. Geoff Tabin on "Ophthalmology in Extreme Environment," and Scott McIntosh and Apa Sherpa on "The History and Culture of Sherpas on Mt. Everest: The SuperSherpas Expedition."

The body of the meeting is loaded with lectures related to avalanche, high altitude, cold weather medicine, survival, travel, trauma, and other important topics for medical professionals in wilderness medicine. It will be of great interest to all doctors, nurses, paramedics, EMTs, rescuers, educators, and others who want to be better prepared to operate and assist others in wintry climates. In addition, the meeting is designed to allow ample time for skiing, hopefully in terrific powder, at The Canyons Resort and other fantastic ski areas in Park City. The first 100 registrants who book three nights or more at The Canyons Resort receive a complimentary one-day lift ticket.

Last year's meeting was awesome, and this one is shaping up to be even better. I intend to be there, and look forward to reporting back to you after a great gathering.

Tags: Wilderness Medical Society, WMS, Wilderness & Mountain Medicine Conference, mountain medicine, Park City, avalanche, wilderness medicine, outdoor medicine, healthline

Labels: avalanche, AWLS, CME, continuing medical education, Wilderness Medical Society, winter, WMS

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Injuries in Avalanche Victims

In the Spring 2007 issue of High Altitude Medicine & Biology, published by the International Society for Mountain Medicine, there is an excellent article entitled Pattern and Severity of Injury in Avalanche Victims (Matthias Hohlreider et al, Volume 8, Number 1, page 56).

There is much discussion in the literature and at mountain medicine meetings about what types of injuries predominate, and the roles of specific anatomical injuries versus asphyxiation from burial under snow in deaths following entrapment of victims in an avalanche.

In this retrospective (looking backwards at medical records) study of avalanche victims who were brought to the University Hospital of Innsbruck, Austria between 1996 and 2005, some important observations were made. There were 105 victims with a total of 49 significant injuries. The limbs, spine, and chest were most commonly injured, but only 2 deaths out of the 36 deaths observed were attributed to injuries, both broken necks. One death was deemed due to hypothermia, and the remaining 33 deaths were felt to be due to asphyxia.

The authors point out that 100 to 150 people die in avalanche accidents each year in North America and Europe. If this study can be reasonably extrapolated to the entire population of avalanche victims, then this lends further support to the notion that rapid response and uncovering the victim (to allow him or her to breathe) is of paramount importance. Transceivers, devices to preserve the airway and provide oxygen, protective shields, and the like are critical adjuncts. While multiple-system trauma may certainly be noted in someone who has fallen roughly in unforgiving terrain composed of ice and boulders, the victim found alive and without an irreversible brain injury caused by oxygen deprivation has a decent chance of survival.

photo courtesy of Swiss Federal Institute for Snow and Avalanche Research Davos

Tags: avalanche, risk, mountaineering, injuries, physician, health, wilderness medicine, outdoor medicine, healthline

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