Background and objective: The aim of my student assignment was to identify prognostic factors that can tell something about the chance of survival in avalanche victims. In addition to study how modern safety equipment may influence these factors, in order to make a good outcome more likely when avalanches strike. I also included a psychological aspect to my study; how the “human factor” can influence risk-assessment and the use of safety equipment in avalanche terrain.
Methods: This literature study is based on articles identified by a systematic search in Pubmed, EMBASE and Cochrane. Papers were also identified from citation lists. In addition parts of the ILCOR guidelines from 2010, and different algorithms for the treatment and handling of avalanche victims were studied. Results: A systematic review on prognostic factors in avalanche resuscitation published in 2010 identified 4 major prognostic factors determining the outcome of resuscitation of an avalanche victim; time of burial, airway patency, core temperature and serum-potassium.
Safety equipment already shows success in intervening with some of these prognostic factors. The presence of heuristic traps, and the maintenance of one’s risk homeostasis, may interfere with a reasonable risk-assessment. This can threaten the benefits achieved from safety equipment. And might give these away in exchange for more freedom to access avalanche terrain.
Conclusions: The available literature identifies four major prognostic factors for survival in avalanche victims, but one must be aware of that the scientific basis for these assumptions are being based mostly on statistics from retrospective studies and case reports.
Safety equipment is clearly contributing to saving life’s, and especially affects the “time of burial” factor.
Heuristic traps and behavior in avalanche terrain can be of much more importance than discussed in scientific studies. Even though this has been recognized for years, it seems this factor should be studied much more systematically. The fact that most of the literature is based on retrospective studies makes it hard to draw final conclusions. Ethical considerations make prospective studies difficult. Therefore, in the future, detailed registration of all accident data, both fatal and non-fatal, is essential for a better understanding of prognostic factors, and the impact of survival equipment and heuristic traps on survival.