Avalanche of FACETS Heuristics & 20:20 Hindsight?

Heuristics and the associated acronym. Interesting review of McCammons paper and discussion with the man himself. 

• "FACETS was never intended to be tool or educational point in and of itself"

• "Numerous studies suggest that merely learning a taxonomy of persuasion tricks does not make people any less susceptible to them"

• "Here we are 20 years later, and people are still dying from the same effects" 

 Link>    AlpTruth and FACETS Acronym

Avalanche Victim Recovery Considerations Part 2

 Davy Gunn American Avalanche Association Pro Member, FIPS Avalanche Working Group and UK Recco Trainer

Learning to dig as a team
Students on an Avy Level 1 course at Glencoe Mountain

●      The definitive locating device is a transceiver. Carry one that's digital and has 3 antennas. And with charged batteries. New ones like the Diract Voice are good

●      The definitive location device is a probe. Carry one that's at least 240cm, preferably 270cm+ The Carbon 280+ pfa is a good one

●      The definitive airway device is a shovel. Carry one that's alu, has a good blade and can convert to a hoe if possible.  Ortovox Pro alu III is a good one

●      RECCO might not save your life but might save a rescuers as being searchable reduces time on scene and exposure to secondary avalanche. Given the longest Scottish survival is 27 hours it might also save your life. Be Searchable

●      Digging out a victim you should attempt to dig in toward the victims chest and head from the side, not above so as not to compress any air pocket. Dig in from below approximately the same distance down showing on your probe mark. If possible have more than one probe in place.

●      Take care when uncovering the mouth and nose and have an experienced avalanche rescuer assess Airway of the ABC's. If  your not experienced class it as open. Clear it of debris. Expose the chest and begin CPR as soon as is practicable. Data suggests starting CPR before complete extrication (if possible ) improves outcomes. Its also hard work so get other climbers and skiers on board to take turns if they offer help.

●      Avalanche Victims may have Trauma, they will also be Hypothermic. So all buried avalanche victims should have further heat loss prevented. Trauma and Hypothermia plus blood loss (contributing to Hypothermia) is a lethal triad.

●      Other victims in a multi burial may be very nearby, or under the first recovered victim. If many victims are buried some may survive for a very very long period due to air spaces among other bodies. A salad of transceiver distances can be confusing. Get as many probes in to make contacts as you can.

●      Multiple burials are resource hungry, messy, require leadership and discipline. Fail to practice these scenarios and its a shitstorm. Spread limited resources too wide and everyone might die. If limited person power get the first located victim out first and fast before moving on. You might at least save one.

Note: Pulse and Breathing may be very hard to detect. Not finding these vital signs does not mean that they are not present. You just may not be able to detect them. Many cases of survival are documented where CPR had been continuous for 5+ hours. Make it good CPR

If you start resuscitation, regardless of how long a victim had been under, you do not cease unless rescuers' lives are in danger or the decision is arrived at from a consensus of experienced avalanche rescuers and medical consensus that it's futile.

Chest compression's may be interrupted for a short time because of evacuation and rescue procedures but continuous unbroken CPR is the goal.

Do not swallow the myth that most Scottish avalanche victims die from trauma. Many undoubtedly do but we should focus on saving those that don't have catastrophic fatal injuries. There are no studies to prove the trauma myth, and plenty of stats from similar maritime snow packs where studies have been done to support that trauma isn't the only killer and only a smaller percentage. My own anecdotal experience is here: https://crankitupgear.blogspot.com/2016/12/triple-h-or-trauma-in-scottish.html

As a personal opinion this trauma fallacy could cost lives by giving the impression being searchable and companion rescue is a waste of time. Follow the international rescue commission guidance and you will not go wrong.

Important reading. Full Article:  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3080528/

Synopsis of Full article: https://earnyourturns.com/9079/avalanche-survival-time-reduced/

Prehospital core temperature measurement in a hostile environment will be unreliable. Unresponsive victims will often be about Swiss Staging HT3 level or more, and so Severely Hypothermic. Use the Swiss Staging scale to describe levels of hypothermia. Learn it. 

Final rescuer thoughts. Responsive survivors may not complain of injury as very cold, and unresponsive victims who maybe alive can be assumed to have occult trauma. Careful handling onto a vacuum matt immobilises the spine, closes the book of the pelvis, and prevents limb fractures from moving. A vac matt also provides good insulation. Better to use this as an SOP as its easy to miss an injury in an avalanche rescue and recovery

NO AVALANCHE OR HYPOTHERMIA VICTIM IS DEAD UNTIL THEY ARE WARM AND DEAD