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Avalanche Victim Resuscitation Checklist From theory to practice Avalanches in Switzerland 2014 - 2015 Alexandre Kottmann Marc Blancher ICAR MEDCOM

Avalanche Victim Resuscitation Checklist - ICAR€¦ · Avalanche Victim Resuscitation Checklist From theory to practice Avalanches in Switzerland 2014 - 2015 Alexandre Kottmann Marc

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Page 1: Avalanche Victim Resuscitation Checklist - ICAR€¦ · Avalanche Victim Resuscitation Checklist From theory to practice Avalanches in Switzerland 2014 - 2015 Alexandre Kottmann Marc

Avalanche Victim Resuscitation Checklist

From theory to practice

Avalanches in Switzerland 2014 - 2015

Alexandre Kottmann

Marc Blancher

ICAR MEDCOM

Page 2: Avalanche Victim Resuscitation Checklist - ICAR€¦ · Avalanche Victim Resuscitation Checklist From theory to practice Avalanches in Switzerland 2014 - 2015 Alexandre Kottmann Marc

Concept approved by ICAR MedCom in 2014 But is it working in the real world?

First steps for testing in Switzerland 2014 - 2015 winter saison

Page 3: Avalanche Victim Resuscitation Checklist - ICAR€¦ · Avalanche Victim Resuscitation Checklist From theory to practice Avalanches in Switzerland 2014 - 2015 Alexandre Kottmann Marc

Avalanche death 2014-2015

http://www.slf.ch/praevention/lawinenunfaelle/unfaelle_aktuell/index_DE

Page 4: Avalanche Victim Resuscitation Checklist - ICAR€¦ · Avalanche Victim Resuscitation Checklist From theory to practice Avalanches in Switzerland 2014 - 2015 Alexandre Kottmann Marc

Distribution

http://www.slf.ch/praevention/lawinenunfaelle/lawinenstatistik/index_DE

Page 5: Avalanche Victim Resuscitation Checklist - ICAR€¦ · Avalanche Victim Resuscitation Checklist From theory to practice Avalanches in Switzerland 2014 - 2015 Alexandre Kottmann Marc

Distribution 2014-2015

GR

VS

BE

SG

UR

GL

VD

OW

TI

Page 6: Avalanche Victim Resuscitation Checklist - ICAR€¦ · Avalanche Victim Resuscitation Checklist From theory to practice Avalanches in Switzerland 2014 - 2015 Alexandre Kottmann Marc

Avalanches 2014-2015

0

5

10

15

20

25

30

35

November December January February March April

total rega

NACA 6-7 rega

total AG Sion

NACA 6-7 AG Sion

Page 7: Avalanche Victim Resuscitation Checklist - ICAR€¦ · Avalanche Victim Resuscitation Checklist From theory to practice Avalanches in Switzerland 2014 - 2015 Alexandre Kottmann Marc

Avalanches with resuscitation

0

2

4

6

8

10

12

November December January February March April

NACA 6-7 rega

NACA 6-7 AG Sion

Rega n=16 / AG Sion n=9

Page 8: Avalanche Victim Resuscitation Checklist - ICAR€¦ · Avalanche Victim Resuscitation Checklist From theory to practice Avalanches in Switzerland 2014 - 2015 Alexandre Kottmann Marc

Adherence in Switzerland

17

83

AVRC X AVRC

n=100 avalanches

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Rega

n=16 NACA 6/7

Page 9: Avalanche Victim Resuscitation Checklist - ICAR€¦ · Avalanche Victim Resuscitation Checklist From theory to practice Avalanches in Switzerland 2014 - 2015 Alexandre Kottmann Marc

First experience in the field

Mostly first time use

Teaching ppt was sufficient to manage the case

The AVR Checklist helped the HEMS doctor

Mostly filled out with pencil

During flight to hospital or at the hospital

Sometimes used as a guide but not filled out.

Page 10: Avalanche Victim Resuscitation Checklist - ICAR€¦ · Avalanche Victim Resuscitation Checklist From theory to practice Avalanches in Switzerland 2014 - 2015 Alexandre Kottmann Marc

Results Avalanche Victim Resuscitation Checklist

Information on Check list Vs Informations on medical file same sample

0.00

20.00

40.00

60.00

80.00

100.00

120.00

Avalanche

Time

face

exposure

time

Burial Time Vital Signs Airway air pocket ECG Temperature

Protocole

AVRC

n = 15 mission where Checklist has been used

about 20% more informations

Page 11: Avalanche Victim Resuscitation Checklist - ICAR€¦ · Avalanche Victim Resuscitation Checklist From theory to practice Avalanches in Switzerland 2014 - 2015 Alexandre Kottmann Marc

Results Avalanche Victim Resuscitation Checklist

100% treated respecting the algorithm

Checklist works: more information for same patient

Page 12: Avalanche Victim Resuscitation Checklist - ICAR€¦ · Avalanche Victim Resuscitation Checklist From theory to practice Avalanches in Switzerland 2014 - 2015 Alexandre Kottmann Marc

Results Avalanche Victim Resuscitation Checklist

Available Informations when using the Checklist Vs NOT USING

NACA 6/7 rega: AVRC = 10, X AVRC = 6

0.00

20.00

40.00

60.00

80.00

100.00

120.00

Avalanche

Time

face

exposure

time

Burial Time Vital Signs Airway air pocket ECG Temperature

AVRC

X AVRC

Page 13: Avalanche Victim Resuscitation Checklist - ICAR€¦ · Avalanche Victim Resuscitation Checklist From theory to practice Avalanches in Switzerland 2014 - 2015 Alexandre Kottmann Marc

Results Avalanche Victim Resuscitation Checklist

NACA 6/7 rega: 2014-2015: n=16

AVRC: n=10

2011-2012: n=15

0

20

40

60

80

100

120

2014-2015 AVRC

2014-2015 protocole only

2011-2012

Education bias or temporary positive effect

Page 14: Avalanche Victim Resuscitation Checklist - ICAR€¦ · Avalanche Victim Resuscitation Checklist From theory to practice Avalanches in Switzerland 2014 - 2015 Alexandre Kottmann Marc

0

20

40

60

80

100

120

2014-2015 AVRC

2014-2015 protocole only

2011-2012

Results Avalanche Victim Resuscitation Checklist

NACA 6/7 rega: 2014-2015: n=16

AVRC: n=10

2011-2012: n=15

Page 15: Avalanche Victim Resuscitation Checklist - ICAR€¦ · Avalanche Victim Resuscitation Checklist From theory to practice Avalanches in Switzerland 2014 - 2015 Alexandre Kottmann Marc

Results Avalanche Victim Resuscitation Checklist

NACA 6/7 rega: 2014-2015: n=16

AVRC: n=10

2011-2012: n=15

0

20

40

60

80

100

120

2014-2015 AVRC

2014-2015 protocole only

2011-2012

Documented information when relevant

Page 16: Avalanche Victim Resuscitation Checklist - ICAR€¦ · Avalanche Victim Resuscitation Checklist From theory to practice Avalanches in Switzerland 2014 - 2015 Alexandre Kottmann Marc

Discussion

Positive Education effect

Awareness of the time cutoff

A cross is also an information

No information = unknown =a cross= better chance possible = information created

Informations directly and easily accessible (burial time)

Page 17: Avalanche Victim Resuscitation Checklist - ICAR€¦ · Avalanche Victim Resuscitation Checklist From theory to practice Avalanches in Switzerland 2014 - 2015 Alexandre Kottmann Marc

Future

Adapt to ERC Guidelines 2015

Today

Page 18: Avalanche Victim Resuscitation Checklist - ICAR€¦ · Avalanche Victim Resuscitation Checklist From theory to practice Avalanches in Switzerland 2014 - 2015 Alexandre Kottmann Marc

Future

Adapt to ERC Guidelines 2015

Values can change but framework don’t

Tomorrow ?

Page 19: Avalanche Victim Resuscitation Checklist - ICAR€¦ · Avalanche Victim Resuscitation Checklist From theory to practice Avalanches in Switzerland 2014 - 2015 Alexandre Kottmann Marc

Future

Big evaluation study in France / Switzerland 2015-2016

Want to be part of it ?

New challenges

Alpine Rescue Switzerland

Mountain Rescuer (helicopter rescue specialists)

Avalanche dog handlers

Ski Patrollers

Questions?

Page 20: Avalanche Victim Resuscitation Checklist - ICAR€¦ · Avalanche Victim Resuscitation Checklist From theory to practice Avalanches in Switzerland 2014 - 2015 Alexandre Kottmann Marc

Avalanches in Switzerland

2014 – 2015

Introducing the Avalanche Victim Resusciation Checklist

Alexandre Kottmann

Marc Blancher

ICAR MEDCOM