❙ Judith Plankensteiner, Peter Mair, Giacomo Strapazzon, Elfriede Ruttmann, Tomas Dal Cappello, Emily Procter, Hermann Brugger ❙
Präklinisches Management von Lawinenopfern in Tirol – Werden die IKAR MEDCOM Richtlinien zur Patiententriage in der Praxis umgesetzt? Management of avalanche victims in the state of Tyrol – Are prehospital triage decisions in accordance with ICAR MEDCOM guidelines?
SUMMARY Aim of this study was to describe the prehospital management and outcome of avalanche victims with out-of-hospital cardiac arrest in the State of Tyrol, Austria and evaluate the adherence to international guidelines for patient triage released by the ICAR-MEDCOM. All avalanche accidents involving out-of-hospital cardiac arrest between 1996 and 2009 in Tyrol, Austria were analysed retrospectively. 170 completely buried avalanche victims were included. 28 victims were declared dead on scene because of trauma. 34 of the remaining patients sustained short burial (<35 minutes), CPR was performed in 27 (79 %) of them, 15 (56 %) were transported to hospital with ongoing CPR and 4 were rewarmed with extracorporeal circulation. None of the 15 patients with short burial admitted to hospital with ongoing CPR survived. Of 108 patients with long burial (>35 minutes), 49 patients had patent or unknown airway status. CPR was performed in 25 (51 %) of these 49 patients and continued to hospital in 14 (29 %) of them; 4 of all 49 patients were eventually rewarmed with extracorporeal circulation, only 1 patient with witnessed cardiac arrest survived. Conclusions: Triage decisions show a poor adherence to ICAR-MEDCOM guidelines. CPR was regularly continued to hospital admission in patients with 77
