Adaptation to the 2017 ICAR MEDCOM Avalanche Victim Resuscitation Checklist

The International Commission of Mountain Emergency Medicine (ICAR MEDCOM) Avalanche Victim Resuscitation Checklist (AVRC) for management avalanche victims1Kottmann A. Blancher M. Pasquier Brugger H. victim resuscitation checklist adaption to the 2015 ERC guidelines.Resuscitation. 2017; 113: 3-4https://doi.org/10.1016/j.resuscitation.2017.01.008Abstract Full Text PDF PubMed Scopus (13) Google Scholar has widespread use. However, rescue and may be very challenging, particularly initially. Those initiating Basic Life Support (BLS) inexperienced. BLS part AVRC, with combined burial time temperature step, even careful thought could cause confusion, indeed been misrepresented in authoritative printed text.2Johnston C. Anderson S. Dallimore J. et al.Oxford University handbook on expedition wilderness medicine.2nd ed. Oxford Press, Oxford2015Crossref Also, this information unclear, adding delay. Furthermore, multiple casualties, simplification AVRC reduce hindrance triage companion which significantly have major influence outcome.3Genswein Eide R. efficiency rescuers minimal training.in: Snow Science Workshop, Whistler2008: 581-590Google In an attempt address these issues while retaining guidance outcomes, alternative layout is presented Fig. 1. adaptation, section more tune standard initiation BLS. Data collection separated avoid impeding intervention. step becomes two separate steps ALS section. “Lethal injury or frozen” box placed Advanced (ALS) sections. One additional added, “CVS unstable” omitted not central main changes proposed. existing cardiovascular instability noted subtext, rather than body where it provide a useful prompt. To introduce would appear twice, prior boxes labelled “follow guidelines”. present patients under 60 min vital signs progress “Follow guidelines” without prompt temperature, further them “ECLS facility” (although detailed subtext). This does occur adapted due its layout. there are 12 clinical (including box), compared 13 AVRC. when updated 2015, changed order right hand limb prioritise “ECG” box, encourage earlier arrhythmia detection. later. ECG monitoring at outset acute care practice4Resuscitation Council (UK) guidelines: ABCDE approach. (UK), London2015Google automatic personnel, my experience. only provides one guide. Mair al.5Mair P. B. Moroder L. Ruttmann E. Is extracorporeal rewarming indicated victims unwitnessed hypothermic cardiorespiratory arrest?.High Alt Med Biol. 2014; 15: 500-503https://doi.org/10.1089/ham.2014.1066Crossref (28) showed poor prognosis asystole core >24 °C. reflected either but perhaps accommodated both minor (e.g. by replacing 30 24 1, new witnessed onset before “airway” box). conclusion, maximum utility, needs balance best evidence against clarity guidance. attempts contribute towards those objectives. author declares no financial personal conflict interest. wishes acknowledge encouragement suggested alterations creating from Hermann Brugger, Jeff Boyd John Ellerton ICAR MEDCOM Derek Milne.