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摘要
Right after avalanche accidents, falls into glacial crevasses are the second most frequent cause of death during alpine winter activities. The objective danger due to snow-covered crevasses is hard to identify in advance and hence accidents are subject to a certain amount of perfidiousness. While in the past clear algorithms were established for companion and professional rescue in cases of avalanche accidents, evidence-based recommendations for both the prevention of and the initial rescue phase in winter crevasse falls have not yet been formulated. The present meta-analysis extracts causes of morbidity and mortality from published crevasse fall accident data over the past 20 years. Statistically derivable influential factors for accident prevention as well as for efficient companion rescue were identified and a rescue algorithm is proposed. A systematic literature search was performed using PubMed, Medline, a manual reference search, examination of relevant publications in annual reports, accident statistics, publications by associations and generally recognized teaching and training literature of the European alpine associations, alpine medical associations, alpine mountain rescue organizations and public bodies addressing alpine safety. In order to identify potential factors for reducing morbidity or mortality 4 publications were consulted and over 600 falls as available from the literature were compared. Due to the wide variety of sources and the low number of publications the degree of evidence is admittedly limited; however, the observed data, for a large part, represent the statistical population of all events described in the particular region in a given period of time. The expected crevasse depth and observed vertical drops in the Alps hardly reached more than a maximum of 30-40 m (mean fall-depth 16 m). Of the observed accidents in crevasses approximately 15 % ended up being acutely life-threatening and 15 % were lethal. Approximately 75 % of the fatal winter events were attributed to asphyxia, the remaining 25 % to trauma. Head injuries are significant and hypothermia is obviously subordinated. Following emergency calls only 30 % of rope parties were able to rescue accident companions by themselves while in only 8 % of the accidents heavy equipment was needed for liberation from the crevasse. We developed an algorithm based on quantitative rationales which is intended to contribute to rapid self and companion rescue in the context of evidence-based recommendations for reducing mortality in crevasse falls. Asphyxia in the context of rope-free glacier skiing is a special form of accident in wintertime. The developed algorithm particularly takes into account the abseiling to fallers threatened by acute asphyxia in the context of companion rescue. The rescue can be managed by a Swiss pulley with ball bearing rollers which, due to the mechanical efficiency, provides the possibility of rescues performed by individuals as they are common in small rope parties or on guided tours. Mechanical total efficiencies of 80 % and a new ultra-light material support this recommendation. Furthermore, the accident analysis suggests that the presence of at least two 30-40 m long ropes in the backpack of the first and the last skier of the group, the constant wearing of a helmet and appropriate braking tools immediately ready for use can be recommended for accident prevention.
- 出版日期2014-3
