[Avalanche rescue 2024-Current recommendations]

Avalanche accidents in which winter sports enthusiasts are involved have significantly increased but the number of deaths remains stable due to better prevention and rescue. Avalanche accidents are frequent in mountainous regions and there are around 100 fatalities each year in Europe. The chances of survival are mainly determined by the degree and duration of avalanche burial, a possible airway obstruction, the presence of an air pocket, the snow characteristics and possible severe injuries. The most frequent cause of death is asphyxia, followed by trauma. Hypothermia accounts for only a minority of deaths. Hypothermic cardiac arrest has a favorable prognosis and justifies prolonged resuscitation and extracorporeal rewarming. The distinction between asphyxial and hypothermic cardiac arrest enables an optimized triage. This article deals with the pathophysiology of avalanche accidents and the management of avalanche victims in the field.