Survival after avalanche-induced cardiac arrest

Area of Science:

• Emergency Medicine
• Environmental Medicine
• Critical Care Medicine

Background:

• Avalanche burial can cause cardiac arrest (CA) and profound hypothermia.
• Establishing criteria for prolonged resuscitation is crucial for these victims.

Purpose of the Study:

• To identify parameters associated with survival in avalanche burial victims experiencing CA.
• To evaluate factors influencing neurological outcome post-resuscitation.

Main Methods:

• Retrospective observational study of 48 avalanche burial victims with CA (1994-2013).
• Collected on-scene and hospital admission data, including pre-hospital temperature.
• Assessed neurological outcome at 3 months using cerebral performance category score.

Main Results:

• 37.5% had pre-hospital return of spontaneous circulation; 30 had refractory CA.
• Survival rate to ICU discharge was 16.7%; favorable neurological outcome was 6.3%.
• Pre-hospital air pocket presence and rescue collapse were associated with survival. Survivors had lower serum potassium and normal coagulation parameters on admission.

Conclusions:

• Survival after avalanche burial and CA is uncommon, with a low rate of favorable neurological outcomes.
• Normal blood coagulation on admission is a potential indicator of survival and warrants further research.