AVALANCHE INJURIES - Medicine for Mountaineering and Other Wilderness Activities - page 451

AVALANCHE TRAUMA
Traumaticinjurytopersonscaughtinavalanchesisdependentontheterrainwheretheava-
lanche occurs. If a person is carried through trees or over rock bands, then traumatic injury
is more likely and may result in death. In one study traumatic injuries occurred in 25 per-
cent of survivors of avalanche accidents that included both partial and complete burials in
Utah and Europe ( Table 30-2 ) . The most common traumatic injuries were major orthoped-
ic, soft-tissue, and head and neck injuries.

Table 30-2 Injuries in Survivors of Avalanche Accidents (Partial and Total Burials)

Inareviewofautopsyreportsfromtwenty-eightavalanchedeathsinUtahoveraseven-
year period, half of twenty-two people caught in avalanches who died from asphyxiation
had mild or moderate traumatic brain injury, which could have caused a depressed level of
consciousness and contributed to death from asphyxiation. All six of the avalanche deaths
caused by trauma had severe head injuries.
RecentdatafromUtahcoveringaperiodfrom1989to2006andinvolvingfifty-sixava-
lanche fatalities found a mere 5 percent mortality from trauma alone and 9 percent from
combined trauma and asphyxiation. A total of 86 percent of the fatalities were felt to be
primarily asphyxiation.
In a European study of 105 avalanche accident burials that produced a 34 percent mor-
tality in Austria, the most common traumatic injuries were lower-extremity fractures and
shoulder dislocations that did not contribute to mortality. Only two of thirty-six deaths
werecausedbytrauma,inbothcasesisolatedcervicalspinefracturedislocations.Asphyxi-
ationwasthecauseofdeathinthirty-three, hypothermia inone.Thisstudyemphasized the
concept of geographic terrain variability and its relationship to the differing contributions
of trauma to avalanche mortality.

PREVENTION OF AVALANCHE ASPHYXIA