Emergency care for avalanche buried patients - a narrative review

Avalanches claim the lives of around 160 winter recreationists and workers in hazardous snow-covered mountain regions worldwide. These fatalities result from asphyxia, trauma, and hypothermia. Survival for critically buried subjects relies on the speed of extrication, absence of trauma, presence of a patent airway and air pocket, immediate field treatment, and rapid transport to the most appropriate hospital by organized search and rescue (SAR) and emergency medical services (EMS). Survival may be improved with helicopter EMS, advancements in safety and rescue equipment technology, early deployment of professional SAR teams with checklists and standard operating procedures (SOPs), and the use of drones. Prehospital and in-hospital care of an avalanche accident requires medical, technical, logistical, and organizational competencies.This narrative review of historic and updated survival curves, professional society guidelines, and snow burial studies, discusses the best practices for prehospital care, triage, transport, and in-hospital management of avalanche patients.