Wilderness Medical Society snowmass 2005 Page 114
Colin Grissom, M.D. "New Hope For Surviving the Avalanche"
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Figure 4. The breathing device intended to prolong survival during avalanche burial
(AvaLung 2TM, Black Diamond Equipment, Ltd., Salt Lake City, UT) by diverting
expired air away from inspired air drawn from the snowpack. The device is worn over all
other clothing. White arrows show flow of inspiratory air, and dark arrows show flow of
expiratory air. The subject breathes in and out through the mouthpiece (A). Inhaled air
enters from the snowpack through the 1-way inspiratory valve on the side of the housing
inside the mesh-protected harness on the chest (B). Expired air leaves the lungs through
the mouthpiece and travels down the respiratory tubing to the housing and then passes
through an expiratory 1-way valve located at the bottom of the housing (B) and travels
via respiratory tubing inside the harness around to the back (C).
Medical Treatment and Resuscitation of Avalanche Burial Victims
The key points that will be discussed regarding assessment and treatment of an
extricated avalanche burial victim are presented in the algorithm in Figure 4. An initial
impression of the level of consciousness is made as the head is exposed and cleared of
snow. Opening the airway and ensuring adequate breathing are the primary medical
interventions. Every effort should be made to clear the airway of snow as soon as
possible and provide assisted ventilation if the breathing is absent or ineffective. These
measures should not wait until the entire body is extricated. If traumatic injury to the
spinal column is suspected, or if there is evidence of head or facial trauma, then the spinal
column is immobilized as the airway is opened, adequate breathing ensured, and oxygen
provided. In the unconscious avalanche burial victim maintenance of the airway may be
challenging in the space limitation of a snow hole where the avalanche victim is being
