Causes of Death Among Avalanche Fatalities in Colorado: A 21-Year Review.

INTRODUCTION: A better understanding of the nature of morbidity and mortality in avalanche accidents helps direct both rescue efforts as well as preventive strategies to reduce fatalities. METHODS: We reviewed all avalanche fatalities from the avalanche years beginning in 1994 to 2015 in the state of Colorado, United States, using the database maintained by the Colorado Avalanche Information Center. For each fatality, we obtained the coroner's official determination of cause of death, and autopsy records if one was performed. We used these records to determine cause of death. Injury severity scores (0-75 scale) were calculated for those victims who underwent autopsy. RESULTS: Mortality information was available for 110 fatalities occurring during the 21-year study period. Of these, 64 underwent autopsy. Asphyxia was the cause of death in 65% of fatalities (72/110). Trauma was the cause of death in 29% of the fatalities (32/110). Of these, the primary cause was multiple system trauma in 38% (12/32), head trauma in 31% (10/32), and spinal injuries in 19% (6/32). Of the victims who died of asphyxia and had autopsy, only 10% (4/42) also had significant trauma, defined as an injury severity score greater than 15. There were 6 fatalities from other causes, including hypothermia, drowning, and primary cardiac arrest. There was no correlation between trauma and mode of travel, avalanche type, or starting zone elevation. CONCLUSIONS: Asphyxia was the primary cause of death in avalanche fatalities in Colorado during our study period. The incidence of fatal trauma was 29% and did not correlate with user group demographics or avalanche characteristics.

Reported Resuscitation of a Hypothermic Avalanche Victim With Assisted Ventilation in 1939.

We present a historical case of a 12-year-old boy who survived a reported avalanche burial in 1939 in the Upper Peninsula of Michigan. The boy was completely buried for at least 3 h, head down, at a depth of about 1 m. He was extricated without signs of life and likely hypothermic by his father, who took him to his home. There, the father performed assisted ventilation for 3 hours using the Schäfer method, a historical method of artificial ventilation, without any specific rewarming efforts. The boy recovered neurologically intact. This case illustrates the importance of attempting resuscitation, possibly prolonged, of victims of hypothermia, even those who are apparently dead.