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Avalanche Victim Resuscitation Checklist
From theory to practice
Avalanches in Switzerland 2014 - 2015
Alexandre Kottmann
Marc Blancher
ICAR MEDCOM
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
Avalanche death 2014-2015
http://www.slf.ch/praevention/lawinenunfaelle/unfaelle_aktuell/index_DE
Distribution
http://www.slf.ch/praevention/lawinenunfaelle/lawinenstatistik/index_DE
Distribution 2014-2015
GR
VS
BE
SG
UR
GL
VD
OW
TI
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
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
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
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.
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
Results Avalanche Victim Resuscitation Checklist
100% treated respecting the algorithm
Checklist works: more information for same patient
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
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
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
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
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)
Future
Adapt to ERC Guidelines 2015
Today
Future
Adapt to ERC Guidelines 2015
Values can change but framework don’t
Tomorrow ?
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?
Avalanches in Switzerland
2014 – 2015
Introducing the Avalanche Victim Resusciation Checklist
Alexandre Kottmann
Marc Blancher
ICAR MEDCOM