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Asphyxial death of a young skier
1School of Physical & Health Education, University of Toronto, Ontario, Canada.
Objective:
Review of the cause of death in fatal downhill skiing accidents is important to prevention: this report concerns a boy found dead with his head buried in powder snow.
Experimental Design:
Case history of an 11-year-old boy who was found dead 4 hours following descent of a steep ski slope.
Setting:
Treatment by mountain rescue team and hospital emergency room.
Patient:
A boy who was discovered immersed head first in one meter of powder snow, with no sign of an avalanche or struggling, and no vital signs. The differential diagnosis included concussion + asphyxia, cervical injury, loss of consciousness from other causes, and hypothermia.
Interventions:
Standard cardio-pulmonary resuscitation, rewarming by bladder irrigation and extracorporeal circulation.
Results:
The rectal temperature, initially 29.4 degrees C, fell further to 23.3 degrees C during evacuation in a heated ambulance. On hospital admission, a blood sample showed creatine kinase 5306 units, K+ 16 mM, pH 6.38, PaCO2 223 Torr, and PaO2 67 Torr. There was no ECG rhythm, and radiography revealed pulmonary edema but no cervical malignment. Emergency measures normalized blood gases, but did not restore cardiac action.
Conclusions:
Death was caused by asphyxia, secondary to mild concussion. The public needs education on the dangers of deep powder snow. Adventurous skiers should wear helmets, and should not ski alone on steep mountainsides.