Avalanches……What the books don’t always tell you.
As the recent series of fatalities and near misses from Avalanches in the Scottish hills show us, they are a clear and present danger for those of us who enjoy walking in the winter wonderland our mountains provide at this time of year.
I’ve been witness to both the frightening spectacle of a full on slide and sadly the aftermath of these catastrophic events and I’ll be honest, it’s always been my biggest fear on winter hills and rescues. I’m fortunate enough to have had considerable training and instruction on avalanches, their cause, their effect and how to take a stab at predicting when they might occur. From my journey through the Winter Mountain Leader scheme, Avalanche courses at Glenmore Lodge with undoubtedly the best in the business of prediction, ongoing avalanche training via rescue seminars and training days I feel I have a pretty good knowledge of what to look for regarding slides but, and here’s the rub, even the very best get caught out as the recent tragedy in the Chalamain Gap sadly proves.
The relieved author after a close call cornice collapse avalanche in Hells Lum Crag
For a long time, many walkers thought avalanches were for the Alps and the higher ranges. Mountaineers in Scotland knew differently and whilst there are many sources of first class information, courses and equipment available to “guide” you in the avoidance of avalanches and even what to do in the event of being avalanched, there hasn’t been a great deal printed with regards to what to do in the rescue and associated first aid phase of recovering a buried casualty.
From a personal point of view, I’d never be on a winter hill without a shovel and a probe at the very least. I’ve had to dig down through snow to reach casualties and the amount of effort to shift the quantities of snow involved is incredible. Again, personally, I wouldn’t entertain anything other than a metal shovel. I’ve seen the plastic / non-metal ones break all too frequently when put to use. Probes are also essential and weigh next to nothing but get the longest one you can afford. I have images of casualties being recovered in snow so deep in Scottish avalanches that NO snow probe would have reached them from the surface, so give yourself and your friends a fighting chance. Having them is not enough though. Learn how to use them and, like your ice axe arrest, you should practice at the start of the season (and whenever you get the chance throughout)
But recovering the casualty is only part of the task in a successful rescue. In 2010 we trialled our first Avalanche Rescue and First Aid course at Venture Medical UK for a group of winter mountaineers. Our aim was not to teach the science of avalanches although we showed crystallisation of the snow and basic pits, the purpose was to teach the importance of what you should do in the aftermath of an avalanche involving a buried casualty to avoid causing further injury or even death.
The first thing to recognise is what exactly is a buried casualty. In avalanche medical terms, the definition of a completely buried casualty is one whose “head and chest is buried”. A partial burial is when the head and chest are free from the snow. The risks of a complete burial should be obvious to all.
Many Scottish avalanche victims are not buried but suffer horrendous, life threatening or fatal injuries as a result of travelling with the sliding mass and striking solid rock on the way down. Immediate first aid and preventing the worsening of the casualty’s condition or complications of that condition are necessary.
Where a casualty is buried, we, as the only real and immediate source of rescue, have some things we need to remember to work towards an effective outcome and mistakes made at this stage can and do costs lives.
Mistake Number 1
Uninjured group members leaving the avalanche site too early.
Unless you have a rescue team training in the same coire as you when the slide happens then YOU are the only real hope of finding the casualty alive. It’s imperative that immediately following an avalanche those uninjured group members remain on site carrying out an intensive search using eyes, ears, probes, avalanche beacons for as long as possible and at LEAST 20 minutes after the slide.
Mistake Number 2
Rescuers unnecessarily trampling all over the avalanche site.
For a full burial victim, the only thing that’s going to save them, other than you digging them out quickly, is an air pocket. Research has shown that those casualties who are buried “face up” have a longer survival chance due to the heat from the back of the head melting the snow down wards and maintaining an air pocket in front of the nose and mouth. Rescuers trampling all over the snow is clearly going to comprise that airway. Horrible thought isn’t it?! Approach the avalanche site only to locate, dig out or take care of the victim.
Mistake Number 3
Removing an avalanche probe after a possible find.
If you think you’ve struck something other than a rock or solid ground (and here is where practice with your equipment comes in, try burying a rucksack just to feel how sensitive a probe can feel) then leave the probe in place as a marker to dig towards. Don’t make life more difficult for yourself or delay recovering your casualty by removing it and having to start again.
Mistake Number 4
Digging down vertically to the casualty.
Standard practice years ago for rescues in the belief that you got to the casualty easier, thankfully procedures have now changed and recoveries are being carried out both quicker AND safer for the casualty as a result. Strategic Shovelling is a name bandied about for the technique now most favoured. Whilst the act of shovelling may seem basic, it is always the most physically time consuming task of any avalanche rescue. Strategic Shovelling involves always starting downhill of the casualty’s location. In burials deeper than a meter, start the excavation about one and a half times the burial depth. Working downhill from the site of the casualty should mean there will be less snow to move and less likelihood of compacting the snow over the victims limited air pocket. Snow debris is normally quite firm and many times it’s easier to chop the snow into blocks and then scoop out in a paddling motion.
Mistake Number 5
Not paying attention to the casualty’s airway or air pocket.
As soon as you can, check the space in front of the casualty’s face and make sure the airway is clear. A compromised airway can only result in death.
Mistake Number 6
Making large movements of the casualty during extrication from burial.
The urgency to get the casualty out of the burial is understandable and its not uncommon for non -professional rescuers to undertake a herculean tug of war with the snow and an unconscious casualty. Sudden Cardiac Arrest (SCA) is a VERY real threat in a hypothermic casualty and sadly very common. Hypothermia will normally be well and truly set in after about 35 minutes of burial and any unnecessary movements of the casualty CAN cause a hypothermic heart to go into Ventricular Fibrillation and SCA. Clear the snow, give them the necessary treatment and insulate appropriately. Leave the evacuation for those equipped.
Mistake Number 7
Not placing an unconscious casualty into the recovery position.
Unconscious casualty – get them into the recovery position and maintain the airway. Remember the risk of SCA.
Mistake Number 8
Not carrying out CPR on an apparently dead victim who was recovered with an obvious air pocket.
There is a saying in avalanche rescue that the casualty is “not dead until they are warm and dead”. There are some important riders to that and I always remember being told that we don’t resuscitate snowmen but if there are no obvious fatal injuries, if you can compress the chest (NOT always possible in an avalanche victim) and certainly if the airway appears clear then start resuscitation. Remember though, once you start it you need to keep going.
Mistake Number 9
Not having suitable equipment.
Now as a bit of a gear freak myself, I’m all too aware that a shovel and probe may not be the sexiest of mountaineering kit when we compare them to the latest cams or screws but they are as equally, if not more, important in keeping you safe in winter mountaineering. Get the best you can afford and ideally everyone in the party should carry the same. Avalanche Transceivers are great bits of kit and incredibly effective but outwith the price range of most hill goers. Or are they? How much did you pay for your top of the range jacket? Think about it, they are a huge investment. There are also loads of new developments over the years, designed in the main for off piste skiers but equally available for the mountaineer. Avalungs, airbags, balls on ropes have all been tested and tried, all with varying results. If you’re interested then Google is your friend. Having the gear is not enough though. Practise with it. Grid probing requires prior practice. You DON’T want to be trying it for the first time while a friend lies buried beneath you. Same with the shovelling and more importantly with a Transceiver.
Lack of knowledge.
There’s absolutely no excuse for having no knowledge of a subject that can potentially kill you or for which alternatively you can assist saving someones life. Get some books, get on a course, get out on the hill with someone that knows what they are talking about. Burying your head in the sand about avalanches could easily result in you being head first buried in the snow. Get on a suitable first aid course as well. Some are more suitable than others but a little bit of knowledge CAN save someones life. Go to the hills long enough and eventually you’ll come across an accident. I guarantee you that.
About the author
Craig Borthwick is a former training officer with a busy Scottish Mountain Rescue Team and has been involved in countless rescues throughout the Scottish Mountains. A qualified outdoor instructor in various mountaineering and outdoor disciplines he has led expeditions throughout the UK and in the Swiss Alps. He trained as a medic and first aid instructor and seeing a gap in suitable first aid courses for the adventurous outdoors lover created Venture Medical UK whose Adventurous Activities Outdoors First Aid course now caters for professionals and enthusiasts alike from throughout the UK. You can read more about Venture Medical UK and the variety of courses they offer by going to http://www.facebook.com/VentureMedicalUK or www.venture-medical.com . SHAG members are entitled to a discount on all Venture Medical UK courses.