Hohlrieder Matthias, Thaler Stephanie, Wuertl Walter, Voelckel Wolfgang, Ulmer Hanno, Brugger Hermann, Mair Peter
Department of Anesthesiology and Critical Care Medicine, Innsbruck Medical University, Austria.
High Alt Med Biol. 2008 Fall;9(3):229-33. doi: 10.1089/ham.2007.1061.
The planning and execution of avalanche rescue missions to search for totally buried avalanche victims are mostly based on personal experience and preference, as evidence-based information from literature is almost completely missing. Hence, the aim of this study was to identify major factors determining the survival probability of totally buried victims during avalanche rescue missions carried out by organized rescue teams (Austrian Mountain Rescue Service, Tyrol). During the 12-year period studied, 109 totally buried persons (56 off-piste, 53 backcountry), were rescued or recovered; 18.3% survived to hospital discharge. Median depth of burial was 1.25 m; median duration of burial was 85 min. The majority (61.6%) of the rescue missions were conducted under considerably dangerous avalanche conditions. The probability of survival was highest when located visually and lowest for those located by avalanche transceiver; survival did not significantly differ between those found by rescue dogs and those located with avalanche probes. Multivariate analysis revealed short duration of burial and off-piste terrain to be the two independent predictors of survival. Whenever companion rescue fails, snow burial in an avalanche is associated with extraordinarily high mortality. Searching the avalanche debris with probe lines seems to be equally effective as compared to searching with rescue dogs. The potential hazard for rescuers during avalanche rescue missions comes mainly from self-triggered avalanches, hence thorough mission planning and critical risk-benefit assessment are of utmost importance for risk reduction.
搜索完全被掩埋的雪崩遇难者的雪崩救援任务的规划与执行，大多基于个人经验和偏好，因为几乎完全缺乏来自文献的循证信息。因此，本研究的目的是确定在由有组织的救援队伍（奥地利蒂罗尔山区救援服务）执行的雪崩救援任务中，决定完全被掩埋遇难者生存概率的主要因素。在研究的12年期间，109名完全被掩埋者（56名在滑雪道外，53名在偏远地区）被救出或找到；18.3%存活至出院。中位掩埋深度为1.25米；中位掩埋持续时间为85分钟。大多数（61.6%）救援任务是在相当危险的雪崩条件下进行的。通过目视定位时生存概率最高，通过雪崩探测仪定位时生存概率最低；被救援犬找到的人与被雪崩探测杆找到的人之间的生存情况没有显著差异。多变量分析显示，掩埋持续时间短和滑雪道外地形是生存的两个独立预测因素。每当同伴救援失败时，雪崩中的雪掩埋会导致极高的死亡率。与用救援犬搜索相比，用探测线搜索雪崩残骸似乎同样有效。雪崩救援任务期间救援人员面临的潜在危险主要来自自行引发的雪崩，因此，全面的任务规划和关键的风险效益评估对于降低风险至关重要。
