title: [Life-saving air supported avalanche mission at night in high alpine terrain].
abstract: This is a case report about a helicopter emergency medical service (HEMS) operation during the night in response to an avalanche accident with two completely buried victims. One of the victims was rescued alive after 9.2 h presenting with a patent airway and an air pocket and was successfully rewarmed with forced air from 23°C core temperature without any neurological deficits. After the rescue the patient developed lung edema which resolved spontaneously within 2 days. The second victim was found dead presenting with an air pocket but solid frozen thorax. The special circumstances of the rescue operation and treatment are presented and discussed. The impact of a frozen chest on resuscitation decisions is presented and discussed with an emphasis on the triage of multiple victims.
authors.affiliation: Schweizerische Rettungsflugwacht (Rega), Zürich-Flughafen, Schweiz, joachim.koppenberg@cseb.ch.
authors.forename: J
authors.initials: J
authors.lastname: Koppenberg
authors.forename: H
authors.initials: H
authors.lastname: Brugger
authors.forename: A
authors.initials: A
authors.lastname: Esslinger
authors.forename: R
authors.initials: R
authors.lastname: Albrecht
mesh_terms: D000293:Adolescent; D017732:Air Ambulances; D055875:Avalanches; D001831:Body Temperature; D016887:Cardiopulmonary Resuscitation; D004632:Emergency Medical Services; D005615:Freezing; D005627:Frostbite / Q000601:surgery / Q000628:therapy; D006230:Hand Injuries / Q000209:etiology; D006801:Humans; D007035:Hypothermia / Q000209:etiology / Q000628:therapy; D008297:Male; D011654:Pulmonary Edema / Q000209:etiology / Q000628:therapy; D018635:Rescue Work; D016414:Resuscitation Orders; D017694:Rewarming; D013696:Temperature; D013909:Thorax / Q000502:physiology; D014218:Triage