Prevelance of Patent Airways during Critical Burial in Avlanaches

The aim of this review is to provide insight into the prevalence of airway patency and air pocket in critically buried avalanche victims.

Below is the Abstract written by Frederik Eisendle and his colleagues, from their paper published in Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine in April 2024:

Abstract

Introduction

Survival of critically buried avalanche victims is directly dependent on the patency of the airway and the victims’ ability to breathe. While guidelines and avalanche research have consistently emphasized on the importance of airway patency, there is a notable lack of evidence regarding its prevalence.

Methods

A scoping review was done in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline extension for scoping reviews. MEDLINE and Cochrane databases, as well as additional manual searching was performed to identify literature reporting data on airway patency and the presence of an air pocket in critically buried avalanche victims. After eliminating duplicates, we screened abstracts and main texts to identify eligible studies.

Results

Of 4,109 studies identified 154 were eligible for further screening. Twenty-four publications and three additional data sources with a total number of 566 cases were included in this review. The proportion of short-term (< 35 min) to long-term burial (≥ 35 min) in the analysed studies was 19% and 66%, respectively. The burial duration remained unknown in 12% of cases. The prevalence of airway patency in critically buried avalanche victims was 41% while that of airway obstruction was 12%, with an overall rate of reporting as low as 50%. An air pocket was present in 19% of cases, absent in 46% and unknown in 35% of the cases.

Conclusions

The present study found that in critically buried avalanche victims patent airways were more than three times more prevalent than obstructed, with the airway status reported only in half of the cases. This high rate of airway patency supports the ongoing development and the effectiveness of avalanche rescue systems which oppose asphyxiation in critically buried avalanche victims. Further effort should be done to improve the documentation of airway patency and the presence of an air pocket in avalanche victims and to identify factors affecting the rate of airway obstruction.

Read the full study

Full Citation:

Eisendle, Frederik & Rauch, Simon & Wallner, Bernd & Brugger, Hermann & Strapazzon, Giacomo. (2024). Prevalence of airway patency and air pocket in critically buried avalanche victims - a scoping review. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. 32. 10.1186/s13049-024-01205-1.

Note: This study was conducted by independent researchers in the field of mountain medicine in conjunction with their clinical trial of SBX. The researchers secured independent funding to perform this analysis and publish their findings.

Safeback is republishing the study due to its relevance to the problem our product is designed to solve.

Useful terms

Airway patency refers to the ability of the airway to remain open and allow for adequate airflow. A patent airway is essential for proper oxygenation and ventilation of the lungs.

Critical burial is the term that describes the total burial of an avalanche victim's head and face in the snow, limiting their access to breathable air. Critical burial does not have to mean the whole body is buried, only that the head and face are fully immersed. Non-critical burial describes partial burial, where the head and face are not under the snow, but the rest of the body might be.

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