Lesson 11: Rescue and Medical Triage

In disasters, responders must evaluate the situation and prioritize their efforts in order to do the greatest good for the greatest number of subjects. Every avalanche search and rescue is different. The contents in this lesson provide guidelines to assist in complex multiple-burial rescues, especially when resources are overwhelmed.

Rescue Triage

Rescue triage is an initial assessment to help prioritize excavation when rescuers do not have direct physical contact with subjects. It considers the availability of rescue resources with survival likelihoods. The following factors influence the probability of survival in an avalanche:

1. Burial Depth Survival Chance:

  • 0-0.5m – 80%
  • 5-1m – 70%
  • 1-2m – 40%
  • >2m – 10%

2. Airway Status: (Assessed when uncovering the head).

  • Buried fewer than 35 minutes – does not affect survival rate.
  • Buried longer than 35 minutes with no air pocket, blocked airway, or sign of subject breathing after burial. Reduced chance of survival. Transport as soon as possible to higher medical care, and continue CPR if practicable.

3. Medical Condition.

  • Lethal trauma – 0% survival chance
  • Hypothermia – 0% survival chance likely if accurate core temperature is lower than 10 degrees Celsius.
  • Vital Signs – absence indicates lower survival rate than with vital signs present
  • Remote Sensing – Positive signal indicates higher survival probability than no signal.

4. Terrain Hazards.

  • Being carried long distances
  • Carried over large cliffs
  • Swept into crevasses
  • Submersion in water

Medical Triage

Medical triage is the assessment of injuries that helps rescuers decide on how to allocate resources devoted to medical treatment. This assessment is conducted for each subject once he or she is extricated. The prioritization of medical care is guided by the following system:

Assign prioritization of avalanche victims using the following algorithm:

Tactical Triage

Tactical triage considers burial depth combined with the medical triage assessment. This system is only appropriate when the rescue team’s resources are overwhelmed.

Evacuation Triage

Priority for evacuation must be determined as subjects are located, excavated, and assessed. Factors to consider in evacuation include:

  • Weather conditions
  • Transport availability
  • Time of day
  • Location and distance from roads and buildings
  • Number of subjects
  • Subject status
  • Location, type, and number of resources available

Personnel assigned to transport subjects off-site must ensure that the Incident Commander is informed and the appropriate resources and subject status logs are updates.