{"id":3207,"date":"2022-03-24T10:03:15","date_gmt":"2022-03-24T09:03:15","guid":{"rendered":"https:\/\/www.pieps.com\/2022\/03\/24\/erste-hilfe-nach-lawinenverschuettung\/"},"modified":"2023-11-15T21:04:04","modified_gmt":"2023-11-15T20:04:04","slug":"erste-hilfe-nach-lawinenverschuettung","status":"publish","type":"post","link":"https:\/\/www.pieps.com\/en\/2022\/03\/24\/erste-hilfe-nach-lawinenverschuettung\/","title":{"rendered":"First aid after an avalanche burial"},"content":{"rendered":"
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First aid after an avalanche burial<\/h1> <\/div>\n\n
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In the event of an avalanche, the primary focus is on locating buried persons \u2013 by sight, sound, avalanche transceiver and probe \u2013 and excavating them. When digging out survivers, once the body is located, the first area to concentrate on is the head. It is vital to ensure a supply of oxygen as quickly as possible. <\/h4>\n
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Authors: Plattner, Dahlmann<\/div>\n<\/div>\n <\/div>\n\n <\/div>\n<\/div>\n<\/div><\/div>
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The first aid measures that first responders need to carry out on-site after excavating survivors are quite complex and should be practiced regularly, in just the same way as searching with an avalanche transceiver needs to be practiced.<\/div>\n<\/div>\n
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Here, we take you through three possible scenarios which you might be faced with following an avalanche burial and explain what first aid measures you should undertake.<\/p>\n

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These are based on the proven ABCDE approach, which is commonly employed by first responders.<\/p>\n<\/div>\n<\/div>\n<\/div>\n

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ABCDE scheme<\/strong><\/td>Situation 1approachable<\/strong><\/td>Situation 2Unresponsive, but breathing<\/strong><\/td>Situation 3unresponsive and not breathing<\/strong><\/td><\/tr>
A <\/strong>Airways<\/td>Stabilise the neck\/cervical spine<\/td>head tilt – chin lift<\/td>head tilt – chin lift<\/td><\/tr>
B<\/strong> Breathing<\/td>check upper body for injuries treat accordingly<\/td>check upper body for injuries treat accordingly<\/td>5 initial rescue breaths CPR<\/td><\/tr>
C<\/strong> Circulation<\/td>check for further injuries & stop any bleeding heat loss<\/td>check for further injuries & stop any bleeding heat loss<\/td>CPR (Coronary Pulmonary Resuscitation) 30:2<\/td><\/tr>
D<\/strong> Disability<\/td>Head injury?<\/td>Head injury?<\/td><\/td><\/tr>
E<\/strong> Else \/ Rest<\/td>improve environment and heat retention reassure & empathise<\/td>improve environment and heat retention<\/td><\/td><\/tr><\/tbody><\/table>
reassess regularly and adapt treatment accordingly<\/strong><\/figcaption><\/figure>\n<\/div>
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ABCDE scheme<\/h2> <\/div>\n\n
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The ABCDE approach is a proven method for treating casualties in an emergency, whether as a paramedic or layperson. In mountain settings in particular, this systematic approach to assessing an injured person gives the first responder a confident approach and prioritises the correct order in which to administer first aid. It is as follows: <\/p>\n

A<\/strong> for Airways
\nB<\/strong> for Breathing
\nC<\/strong> for Circulation
\nD<\/strong> for Disability
\nE<\/strong> for Environment\/ Else<\/p>\n <\/div>\n\n <\/div>\n<\/div>\n<\/div><\/div>

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Situation 1: Victim is responsive<\/h3> <\/div>\n\n
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If the victim is responsive, there is less need for urgent immediate action. Continue carefully digging them out of the snow, and then begin running through the ABCDE approach. There is also no need to hurriedly transport the victim anywhere. <\/p>\n

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A<\/strong> Since the victim can talk, there is no cause for concern about their airways being clear. But because of the force of the impact of the avalanche, care should be taken with the neck. Try to stabilise the cervical spine area by supporting it with your hands. <\/p>\n

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B<\/strong> For B (Breathing) assess the frequency and strength of the victim\u2019s breathing to check for any injuries to the chest. Make the victim as comfortable as possible. <\/p>\n

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C<\/strong> For C (Circulation) check for injuries and stop any bleeding. Internal bleeding cannot be assessed or treated. It is extremely important to keep the victim warm\/ prevent heat loss: That\u2019s because haemostasis (blood clotting) only functions well if the body temperature is as close to normal as possible \u2013 shivering is a warning sign here. <\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n

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D<\/strong> (Disability\/neurological status) is about checking the victim\u2019s neurological functions, because avalanches can causehead injuries.<\/p>\n

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E<\/strong>(Environment, Else) improve the victim\u2019s exposure and heat retention with a bivouac bag, space blanket or similar. How much effort is required here depends on when the professional rescue services are due to arrive: The shorter the waiting time (helicopter on its way), the less important it is to make big changes to the victim\u2019s environment. If the head is in an awkward position, you might consider repositioning onto a freshly shovelled area, so it is aligned with the victim\u2019s body, making sure this is done with minimal manipulation (neck vertebrae).<\/div>\n<\/div>\n
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So, clear away snow from around the head of the victim, put a hat on their head (if not already wearing one) raise their jacket hood, and cover them with a down jacket<\/strong><\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n <\/div>\n\n <\/div>\n<\/div>\n<\/div><\/div>

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Victim is unresponsive (Situation 2 & 3)<\/h3> <\/div>\n\n
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\u201cBreathing normally\u201d<\/strong> means: Once airways have been cleared if necessary (from snow, vomit etc.) and the chin has been lifted, breathing is assessed by looking, listening, and feeling for air exchange and establishing whether there is regular movement of the chest cavity at sufficient intervals (10 x\/ minute or more). If in doubt or uncertain, the victim is to be categorised as \u2018not breathing\u2019.<\/p>\n

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\u201cNot breathing normally<\/strong>\u201d means: Breaths are either too infrequent (fewer than 9x\/ minute), barely visible (chest does not rise and fall) or too fast (more than 30x\/ minute). If the chest rises and falls at a normal pace, but you cannot feel any breath\/ vapour against the the back of your hand, inspect and clear the airways once again from obstructions like snow, vomit etc., and check the chin is correctly lifted to extend the airways in a straight line.<\/p>\n<\/div>\n<\/div>\n

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If normal breathing cannot be ascertained, CPR (cardiopulmonary resuscitation) should be initiated.<\/em><\/p>\n<\/div>\n<\/div>\n

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Both scenarios require immediate appropriate action, because the victim\u2019s life is in danger. However, it is important not to rush or go into \u2018action mode\u2019, but to proceed calmly, quickly and effectively. As with any first aid situation, and in the mountains in general, slow and steady wins the race.<\/p>\n

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In contrast to situation 1 the rest of the body is excavated as fast as possible because the first aid measures in this case can only be carried out on the person if they are on level ground or a prepared area of snow (compressed).<\/p>\n<\/div>\n<\/div>\n <\/div>\n\n <\/div>\n<\/div>\n<\/div><\/div>

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Situation 2: Victim is unresponsive, but breathing (normally)<\/h3> <\/div>\n\n
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Work through the ABCDE protocol. Work through the ABCDE protocol. The emphasis here is on A <\/strong>for clearing the airways from obstructions and ideally performing a chin lift (also known as head tilt chin lift).<\/p>\n

Then concentrate on B<\/strong> (breathing) by repeatedly asking yourself whether their breathing rate is still sufficient.<\/p>\n

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For C<\/strong> (circulation), proceed as in Situation 1 (victim is responsive), and likewise with D<\/strong> (disability) and E<\/strong> (environment).<\/p>\n

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USING THE HEAD TILT CHIN LIFT TO KEEP AIRWAYS CLEAR. PHOTOS: ARGONAUT.PRO<\/a><\/p>\n

In this particular case, the airway needs to be manually assisted to remain open, and there is a risk of breathing deteriorating at any moment.<\/p>\n

Therefore:<\/strong><\/p>\n