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Medicine for the Outdoors
Medicine for the Outdoors

Dr. Paul Auerbach is the world's leading outdoor health expert. His blog offers tips on outdoor safety and advice on how to handle wilderness emergencies.

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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

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Dr. Paul S. Auerbach is the world’s leading authority on wilderness medicine.

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