AVALANCHE INJURIES - Medicine for Mountaineering and Other Wilderness Activities - page 454

as the device has evolved into user-friendly equipment incorporated into a backpack. The
AvaLung's®fullpotentialforreducingdeathbyasphyxiationrequiresseveralyearsofana-
lysis with increased usage.
PREVENTION OF AVALANCHE BURIAL
Absolute prevention of avalanche burial can only be accomplished by complete avoidance
of avalanche terrain. All backcountry enthusiasts, including over-snow travelers and
climbers, are at risk. The current attitude in Europe, aside from wise and proper backcoun-
trytravelandtheuseoftransceivers,probes,andshovels,issupportiveofproactivedevices
to prevent burial when caught in an avalanche. The avalanche air bag system (ABS) has
proven extremely effective for more than fifteen years throughout the alpine countries of
Europe by greatly increasing the odds of a surface or near-surface burial, in addition to
making rapid visual localization of the air bags possible. The ABS is triggered by pulling a
ripcord on the front strap.
From February 1991 to April 2006, 106 persons deployed the system in an active ava-
lanche accident. Of these, fifty-two finished on the surface, forty-two were only partially
buried and were easily extricated, and eleven were completely buried but with the balloon
visible on the surface for rapid localization and recovery. Only one person with a deployed
balloon died because a second avalanche buried the balloon deeply into a terrain trap.
The system works by the principle of inverse segregation of particles in a laminar flow,
suchasoccursinavalanches.Thelarger-volumeparticlesrisetothesurface,whereassmal-
lervolumesareforcedtothebottom.Theballoonseffectivelyincreasethesizeandvolume
of the wearer which favors dynamic movement into the upper flow and a greater chance of
a surface burial.
Unfortunately, neither the ABS device nor the AvaLung® effectively prevents trauma.
To date, the ABS has been difficult to obtain in the United States due to shipping regula-
tions involving the pressurized canister.
TREATMENT OF INDIVIDUALS BURIED BY AVALANCHES
As the buried person's head is exposed and cleared of snow an initial impression of the
level of consciousness and presence of an air pocket should be obtained. Opening the
airway and ensuring adequate breathing are the first medical interventions. Every effort
should be made to clear the airway of snow as soon as possible. Ideally, ventilation should
be assisted with a bag-valve-mask device or a pocket mask if breathing is absent or inef-
fective, and an oral or nasal airway should be inserted if the person is unconscious. These
measures should not be delayed until the entire body is extricated.
If traumatic injury of the spinal column is suspected, or if there is evidence of head or
facial trauma, the spinal column must be immobilized as the airway is opened, adequate
breathing ensured, and oxygen provided. For unconscious persons, maintenance of the air-