Patient and rescuer safety: recommendations for dispatch and prioritization of rescue resources based on a retrospective study of Norwegian avalanche incidents 1996–2017

Abstract

BackgroundAvalanche emergency response should address current accident scenarios to optimize survival chances of victims and to keep rescuers safe. The purpose of this article is to present a basis for evaluation and necessary adjustments in dispatch, prioritization, and management of Norwegian avalanche rescue operations.MethodsThis is the first peer-reviewed retrospective study of all Norwegian avalanche incidents registered by the two Joint Rescue Co-ordination Centers (JRCCs) in the period 1996–2017 that describes the characteristics and trends of rescue missions and victims.ResultsThe Norwegian JRCCs have registered 720 snow avalanche events, with a total of 568 avalanche victims, of which 120 (21%) died. Including those fatally injured, a total of 313 avalanche victims in 209 accidents were treated as patients (55%), and we saw > 1 patient in 24% of these operations. Norwegian avalanche victims were partially or completely recovered prior to the arrival of rescuers in 75% (n = 117) of all rescue operations. In the remaining 25% of cases, the rescue service located 62% (n = 55) of the avalanche victims visually or electronically. In 50% of the 720 incidents, rescuers spent time searching in avalanches with no victims.ConclusionsThis survey indicates that we have experienced a shift in Norwegian avalanche rescue: from search for missing persons in the avalanche debris to immediate medical care of already-located patients. The findings suggest that a stronger focus on both patient and rescuer safety is necessary. The patients must be ensured the right treatment at the right place at the right time and the allocation of rescue resources must reflect a need to reduce exposure in avalanche terrain, especially in cases with no affirmed victims. We present a flowchart with a recommended rescue response to avalanche accidents in Norway.

Wilderness Medical Society Clinical Practice Guidelines for Prevention and Management of Avalanche and Nonavalanche Snow Burial Accidents: 2024 Update

“…130 Conditions such as inclement weather and pilot proficiency in mountain environments can significantly affect helicopter performance and safety. 119,131 Recommendations. We suggest professional rescue teams should only use helicopters with crews specifically trained in avalanche rescue, if possible.…”

“…130 Conditions such as inclement weather and pilot proficiency in mountain environments can significantly affect helicopter performance and safety. 119,131…”

A systems thinking approach to safety in Norwegian avalanche rescue operations

“…The results from this study indicate that they do not meet the expectations laid down in instructions (Regjeringen, 2013; and guidelines (NRR, 2012). This contributes to a deficient control of rescue operations in the critical first hour, and a suboptimal dispatch and prioritization of rescue resources could affect the survival chances of avalanche victims (Lunde & Tellefsen, 2019).…”

“…In many of these situations, it is uncertain whether victims are involved in the avalanche or not, and high-risk search operations may be initiated without clear indications of a critical situation (Lunde & Njå, 2019). In a recent survey, it was found that fifty percent of all recorded Norwegian avalanche rescue operations in the period 1996-2017 involved no victims (Lunde & Tellefsen, 2019). This high number of rescue operations with no human victims puts an extra burden on the rescue services and their representatives.…”

Green HEMS in mountain and remote areas: reduction of carbon footprint through drones?

“…Refuse: HEMS teams in search and rescue missions are frequently deployed for the assessment of the scene safety of ground-based personnel in unclear and difficult-to-reach areas. For example, 50% of the avalanche rescue operations in Norway did not involve any victims [ 4 ]. Drones could assist in the assessment of the scene, the patient search, and the delivery of medical equipment [ 5 ].…”