Witnessed Cardiac Arrest in a Hypothermic Avalanche Victim Completely Buried for 2 Hours.
Wilderness & environmental medicine · 2021-01-29 · Case report
Abstract
A 34-y-old skier triggered a wind slab avalanche and was completely buried for over 2 h. After extrication by rescuers, the victim was breathing and conscious. Despite directions from the rescuers against standing up, the victim struggled to free himself and ultimately stood upright before collapsing in cardiac arrest. The rescuers performed cardiopulmonary resuscitation during transport to a nearby trailhead, where a helicopter emergency medical services crew found that the victim was in ventricular fibrillation. After further resuscitative efforts, including advanced life support, the victim was declared dead at the scene. Afterdrop and circumrescue collapse were the most likely triggers of cardiac arrest. This case highlights a need for rescuers, emergency medical services, and hospitals to be prepared to care for victims with hypothermia. To prevent circumrescue collapse, victims with hypothermia should be extricated gently, should not be allowed to stand, and should be placed flat. This may be difficult or impossible, as in this case. Hypothermic victims in cardiac arrest may require prolonged cardiopulmonary resuscitation, preferably with mechanical compressions, during transport to a hospital that has protocols for rewarming using extracorporeal life support. Resuscitation from hypothermic cardiac arrest should not be terminated before the victim has been rewarmed.
Abstract © the authors or publisher, via PubMed. Reuse and removal
Tags
Helicopter & air ambulance · Extrication
Related articles
- Full recovery of an avalanche victim with profound hypothermia and prolonged cardiac arrest treated by extracorporeal re-warming. (Resuscitation, 2008)
- Emergency care for avalanche buried patients - a narrative review. (Scand J Trauma Resusc Emerg Med, 2026)
- Experience with helicopter rescue missions for crevasse accidents. (High Alt Med Biol, 2010)
- Identification of the technical and medical requirements for HEMS avalanche rescue missions through a 15-year retrospective analysis in a HEMS in Switzerland: a necessary step for quality improvement. (Scand J Trauma Resusc Emerg Med, 2018)
- Field management of avalanche victims. (Resuscitation, 2001)
- Management and outcome of patients with cardiac arrest after avalanche accidents in the Swiss Alps: A retrospective analysis. (Resusc Plus, 2025)