Avalanche Rescue Basics: First Aid After a Burial

Avalanches remain one of the most serious hazards in winter mountain sports, particularly in ski touring, freeride, and winter mountaineering. Survival after an avalanche burial depends not only on rapid companion rescue, but also on correct first aid immediately after extrication. Poor handling after rescue can significantly worsen outcomes, even when the victim is found quickly.

This article focuses on first aid priorities following avalanche burial and the critical actions required during the minutes after extrication.

Types of Avalanche Involvement

Avalanche incidents vary in severity:

  • Partial burial, where the victim remains visible

  • Complete burial, requiring full transceiver search and excavation

  • Multiple burials, significantly complicating rescue priorities

Each scenario demands clear role distribution and calm decision-making.

Immediate Priorities After Extrication

Once the victim is uncovered, first aid must begin immediately:

  • Clear the airway first, removing snow and ice from the mouth and nose

  • Assess breathing and consciousness

  • Begin rescue breathing if the victim is not breathing

  • Avoid unnecessary movement until initial assessment is complete

Time is critical, but actions must remain controlled and systematic.

Hypothermia Management After Burial

Avalanche victims are almost always hypothermic:

  • Insulate the victim from the snow immediately

  • Add dry layers and wind protection

  • Handle gently to avoid triggering cardiac arrhythmias

  • Avoid active rewarming if the victim is unconscious

Hypothermia management continues until professional rescue takes over.

Trauma Assessment and Management

Avalanches often cause blunt trauma:

  • Assess for chest, head, and spinal injuries

  • Immobilize suspected fractures where possible

  • Control bleeding using direct pressure

  • Treat the victim as a trauma patient even if initially responsive

Trauma and hypothermia must be managed simultaneously.

Cardiac Arrest and Resuscitation Considerations

Special considerations apply in avalanche rescue:

  • If airway was blocked, focus on ventilation first

  • Prolonged resuscitation may be justified in hypothermic patients

  • Continue CPR until rescue services advise otherwise

Cold victims may appear lifeless but remain salvageable.

Group Management During Rescue

Effective group coordination is essential:

  • Assign clear roles immediately after extrication

  • Keep non-essential members warm and out of the fall line

  • Prepare for prolonged care if evacuation is delayed

Poor group management can turn one accident into multiple casualties.

When to Call for Professional Rescue

Rescue services should be contacted as early as possible if:

  • The victim was fully buried

  • Consciousness is altered

  • Trauma is suspected

  • Resuscitation is required

Early communication improves rescue coordination and outcomes.

Conclusion

Avalanche rescue does not end when the victim is uncovered. Correct first aid in the minutes following extrication is critical and often determines survival and long-term outcome.

Training, rehearsal, and calm execution are essential skills for anyone participating in winter mountain sports in avalanche terrain.

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Winter Mountaineering Safety: Risk Management in Snow, Ice, and Mixed Terrain