15 December, 2013

The Problem With Avalanche Rescue

Nearly everyone who takes an CAC AST 1 or 2; ITP 1,2,3; AAA Level 1-2-3; or any other form of avalanche course knows that if you have to rescue someone you need to act fast.  Most people won’t last past 12-15 minutes under the surface, one third may suffer from trauma, and others may be buried deep.  There is always practicing rescue from right beside the slide path, but while practicing right beside the slide path is for practice it’s not realistic.  Typically travel times must be factored in, hazard, and transitioning from downhill to uphill in some cases.  Then there are a maraud of other factors to think about, so let’s start going through the problems in order to put together a bigger picture of a rescue.

(Video Above:  Unbelievably lucky guy in an big avalanche, with a helicopter on scene, and rescue team on standby.  Not the reality that backcountry skiers have the luxury of.)
First, before anything, everyone in the group needs to have a 3 or 4 antenna avalanche beacon, anything less is out dated technology and should be replaced (why not just have the best and newest beacon, your life is worth it right?).  Avalanche beacons are great, but do have issues like any piece of electronics, and many people choose to either disregard those bugs or just don’t know about them.  So what can interfere with you Beacon signal?  Any piece of electronics within 50cm of the Beacon such as Cell Phones, camera’s (especially those with GPS), GoPro camera’s mounted on the chest (GoPro on the head is fine), GoPro wireless & bluetooth controllers, iPods, heated gloves, magnets on the front of jackets, and even within a recent study that says candy bar wrappers that have foil in their wrappers that sit in the same vicinity as the beacon could create issues!  These also aren’t just problems for searchers, but those who are buried, so be weary and keep your gizmos, well away from your beacon, inside your pack.  Always wear your beacon under your jacket (never keep it in your pack).

Now those skiers and snowboarders who have high DIN, or non-releasable bindings, have a number of things to be concerned about.  While caught in an avalanche, skis/snowboards, and poles strapped to the hand act as anchors and pull the person under the surface of the snow in the avalanche.  They can also cause trauma, twisting and pulling body parts in different directions.  So the number one goal is staying on the surface, followed by avoiding obstacles if possible, and covering your mouth with your arm all while attempting to swim off the side of the slide.  One thing that can help is an avalanche airbag, which is the only product on the market that attempts to prevent burial.  So if you can’t get out of your skis or board, you may be buried deeper and/or with trauma issues for your rescuers to deal with if they get to you in time.
(Photo Above:  Justin Ormiston shredding the committing N Face of Mt Fitzsimmons in thigh deep snow.  Better be sure it's stable, there's no fooling around with this big face.  Terrain traps, steep open large terrain, and big spacing between partners.)
Distance is the next key issue.  How far away is everyone from the avalanche and it’s deposition zone?  Are they above and can quickly ski down in order to start searching, or do they have to put their skins on and start running uphill to the site?  Being far away, halfway down a mountain, and/or in a less than ideal proximity adds a huge amount of time to the rescue effort.  Did that person get swept into a terrain trap?  Speed is essential at this point, this is made from fitness, ability, distance, searching capabilities, skill and strategic shovelling.
(Photo Above:  Natural avalanche, due to the trees, this area would almost certainly result in trauma if caught in a slide.)
Now your friend has a beacon on, doesn’t have a cell phone around his/her beacon, got rid of their skis, and was lucky enough to be buried close enough to you and the surface for you to get to them in time.  Now what?  Many avalanche victims suffer from trauma and can die from that alone.  Some may be unconscious, not breathing and/or have a blocked airway, unable to walk, spinal injury, hypothermic, etc.  Combine all your skills from avalanche rescue, wilderness first aid, survival, rescue planning, as well as helicopter knowledge, and you have half of the equation done to getting someone out alive.  You also need the right gear to drag or move that person to safety, deal with their injuries, and get them to medical care immediately.  How will you move them in waist deep snow, will moving them make the injury worse, and do you have enough light left in the day to get home?  
(Photo Above:  Practicing moving patients in a toboggan through undulating terrain, complete with cliffs, and deep snow.)
Now let’s say the incident has happened early enough in the day, the weather and wind is good enough for a helicopter to fly, and you need to get that helicopter in.  Most helicopters need a spot to land where the pilot has depth perception (small tree, rock, anything that when they come in and the snow gets blown up in the air they can maintain sight).  They also need a flat area that is large enough to land, otherwise they will be forced to sling a patient out and wind/visibility really becomes a factor.  Bell 212’s have a 48ft blade span and require clear 100x100ft area to land, and prefer to land into the wind.  Bell 407’s are a bit smaller, with room for less casualties, and have a 35ft blade span allowing them to land in only a slightly smaller area than the bigger 212.  There are many other helicopters out there, but these are just two of the classics, although we do see a few more B3’s out there from time to time.  So if you do have a spot, you will need to let them know if they will need it in stretch configuration, or seated.  As well as if they need to bring a paramedic with Advanced Life Support training, and the type of gear they may need to assist you.  A complete description of your problem is vital.
(Photo Above:  Testing the spinal board patient transport setup in the Bell 407)
Time between avalanche and getting to the hospital is also critical.  Seriously injured patients may only have the ‘golden hour’ to get advanced medical help, whereas others may last much much longer depending on the severity of the injury.  Hospital distances and resources must now also come into question, which hospital is best suited to deal with the issue at hand, and how far away is that.  For example, it’s my understanding that the Whistler Health Clinic can only accept Twin Engine helicopters such as the 212 at this time, but not the 407 which is required to land at the heliport and rendezvous with an ambulance adding to rescue times.  So it’s important to have an idea of what kind of health care is closest to you, and how easy it is to get there.

There is a lot to think about when it comes to a full fledged rescue.  SAR Teams are amazing at what they do, and will always be there working as hard as possible to get you and your friends out.  However, make no mistake, if a handful of these problematic factors are present, they compound on each other and make rescue much more difficult.  The key is to identify potential problems first, and consider them with your trip planning and also with how you ski in the backcountry.  Habits such as not skiing with a cell phone that is on and keeping it your backpack is great, regrouping at safe and smart locations is vital, and being prepared for anything is key.  By thinking of the consequences of a rescue in the terrain we're in before hand, we can make better decisions, and set ourselves up for success if we are faced with the worst.  We are very vulnerable, just how vulnerable is up to us.

13 comments:

  1. You forgot one thing. How can you call for help if you only have a cell phone with no service!

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  2. Haha you're right Corey. I think that's another topic too. 2 forms of communication always, such as radio, cell, sat phone, or spot/delorme device. As well as the knowledge of where you can find cell service! There we are already writing the next post!

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  3. Thanks Alex...

    Curious what you thoughts are on these for a cheap rescue sled.

    http://www.pieps.com/en/product/pieps-bivy

    Cheers

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  4. Thoughtful post, thanks!. Im curious if heart rate monitors (chest strap kind) are an interference issue? I always leave mine at home when wearing a beacon but was curious if thats being overly paranoid or not? Also, while I agree that SAR will always be working hard if available, the reality is (as a SAR member) that by the time they mobilize, organize and get there in most locations, its going to be a body recovery not a rescue. Your buddies are your best bet (after trying to avoid such a catastrophic event in the first place of course). As my son says, "Dad, you have to act like a secret agent in enemy territory" while in the backcountry!

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  5. Hey Guys,

    Anon, the Pieps rescue sled/bivy looks cool, and I work with a few people who use them, which tells me they work well. I have not tried one but look like they would be a great addition over a rescue bubble, as they are incredibly small and light. The Alpine Threadworks is my favourite, but I'll have to test one of those for sure.

    Jesse, that's a good question. I can't say for sure if the HR monitor is going to interfere. However, I would theorize that it would as it had electronic parts, batteries, receptors, and is still fairly close to your beacon that it will interfere. And on your second point, you hit the nail on the head.

    Thanks for the comments!

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  6. Good work Alex.I think anyone roaming around the backcountry would benefit from a realistic rescue scenario involving real terrain, distances and carries etc. It is certainly a better way than a transceiver session in a 20mX20m clearing behind the hut to realize just how limited we really are out there. Add to this a bit of knowledge of physiology/trauma care and the picture becomes pretty grim. Many (and I would dare to say more and more) people are "blissfully" ignorant and treat the backcountry like a ski resort. Thanks for spreading the knowledge.

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  7. Thanks for the comments AJ, you opened my eyes to this years ago! I think the best avalanche scenario training would be a transition to uphill, sprint uphill to the site, search, first aid, and evac on 300m course to a safe zone for full value. On the few AST's I teach these days, after a scenario I ask people if they can move a "victim" with a broken leg to the side of the slide path on their own. Most are stumped.

    Have a great winter!

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  8. "keep you (sic) gizmos well away from your beacon inside your pack." Beacon (transceiver) inside your pack? Am I reading this right? Surely we should be encouraging people to keep their transceivers near their bodies, under layers of clothing. A pack can be ripped off in an avalanche. I presume you meant, "keep your gizmos inside your pack, well away from your transceiver."

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  9. You got it Steve. Never keep the transceiver in your pack, it should always be worn under clothing and jacket, but as long as it is easily accessible. I have edited the article if it wasn't clear enough.

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  10. Great Alex! You have posted nice article and all pics are really awesome.

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  11. Such a beautifully explained about Avalanche Rescue's problem. Very nice post. I think every skier have to read it.


    More info

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  12. Alex you are really nice because you have done your work very amazingly. Avalanche Rescue's problem is very nice post. I love to read it again and again.


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