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Electronic letters to:
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Electronic letters published:
![[Read eLetter]](/icons/misc/sectionDOWN.gif){kind=icon}
Re: Study limitations
Need for legislated standards?
Study limitations
Compression Asphyxia vs Hypoxia
Avalanche trauma, prevention vs treatment
Avalanche mortality
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John G. Kelly Canadian Avalanche Centre
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jkelly{at}avalanche.ca John G. Kelly
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Mr. Baumann has been a longstanding proponent of sharing of avalanche
incident information. This is also a goal of the Canadian Avalanche
Centre. Mr, Baumann's assertion that the Canadian avalanche community does not share near miss avalanche incident information, however, is factually incorrect. Canada has the only system of real-time peer-to-peer sharing of avalanche incident information in the world. This system has been in operation for two seasons at the Canadian Avalanche Centre's website: http://www.avalanche.ca/IncidentReport. During this time over 200 near-miss and fatal avalanche incidents have been reported and publicly shared, receiving over 100,000 views. These incidents are crosslinked to relevant regional avalanche bulletins and area-specific discussion forums In addition Avalanche Accidents in Canada volume 4 has been converted to a free publicly downloadable document also available on the Canadian Avalanche Centre website's digital library. http://www.avalanche.ca/CAC_Knowledge_DigitalLibrary < br/> Avalanche Accident's in Canada volume 5 is in production currently with access to an impressive array of incident data from public and commercial sources. This volume is slated for publication in winter 2010. Dr. Boyd was well aware of the wealth of incident data available to him through the CAC, but the parameters of his study were better served by constrained investigation of the fatality dataset. Mr. Baumann (along with many others) has been persuasive in urging greater public access to avalanche incident reporting and case histories. It’s curious that he chooses not to acknowledge the considerable advances that have been made in this area in the short four years since the formation of the CAC. Conflict of Interest:None declared |
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Frank Baumann
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fwbaumann{at}shaw.ca Frank Baumann
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The study found that 21% of the avalanche deaths involved heli and snowcat skiers and boarders who would have been under the care of a paid mountain guide; a high number in itself. However, according to available public records, at least 15 of the 62 backcountry skier deaths were also people under the care of a paid guide. This means that at least 57 of the 204 avalanche deaths in British Columbia and Alberta- or 28% of the total- involved people under the care of a paid guide in the mountains. Unlike Europe, there are no legislated standards in Canada for guides; anyone can call themselves a mountain guide. Perhaps this needs to change. Conflict of Interest:None declared |
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Frank W Baumann
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fwbaumann{at}shaw.ca Frank W Baumann
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In terms of contributing to public safety and reducing avalanche incidents, this study has a severe limitation: it is based only on fatal accidents where reporting is mandated by the Coroner's Act and does not consider the large number of non-fatal accidents and near misses which are no longer reported in case history studies by the Canadian avalanche community. The lack of information on avalanche incidents does not allow the all-important educational benefits of case history studies to be realized, and also does not allow critical data to be compiled so that trends can be analyzed. In this regard, Canada is virtually alone in the civilized world in not completing such case history studies. Conflict of Interest:None declared |
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Frank W Baumann
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fwbaumann{at}shaw.ca Frank W Baumann
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It is unfortunate that this study was not able to distinguish whether an asphyxia death was due to compression caused by the weight of overlying snow that did not allow diaphragm movement, and would therefore result in rapid death, from that caused by hypoxia due to ice mask formation. Given that overlying avalanche snow produces vertical pressures of about 4 to 5 kPa per meter of snow depth, it is likely that compression asphyxia is more common. If this is true, then it emphasizes the need for avoidance of avalanche burial and for using safety products, such as avalanche flotation devices, as opposed to avalanche breathing devices. Conflict of Interest:None declared |
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Dale Cole
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dalecole{at}shaw.ca Dale Cole
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It is as a doctor and retired backcountry skiier, that I read Dr. Boyds's article(CMAJ 2009;180;507-511) with much interest. His epidemiologic study confirms what I've been taught in various snow safety courses. And while I support his call for better onsite trauma care for avalanche victims, this will not be available for a significant number of them. In Dr. Boyd's article 41% of victims are carrying their first aid gear on their back( backcountry skiiers, mountainiers, iceclimbers, and hikers).The relevance of what goes in your pack is measured in fractions of a kilogam. Advanced trauma care gear is very unlikely to be carried by these user groups.In Canada, even with rapid notification of search and rescue with a radio, which are rarely carried, a helicopter is often hours or longer away. Life threatening trauma in Canada's backcountry will continue to carry a grim prognosis for many, regardless of rescuer capability. I would therefore suggest research by experts like Dr Boyd go into effectiveness of preventive measures. Questions to consider: Whos's taking proper avalanche safety courses? Are they making a difference? How do you measure that? How do you target groups like out of bound skiers? I suspect that the cost/benefit analysis of safety courses vs helicopter supported advanced trauma care would support the former. Sincerely; Dale Cole MD CCFP Calgary Conflict of Interest:None declared |
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Errol S. Prasad DynaLIFE dx Laboratories
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errol.prasad{at}dynalifedx.com Errol S. Prasad
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Dr. Boyd et al. have documented a very thorough review of the avalance victims. Some cost analysis would be beneficial. More than one- third of the mortalities are "self-inflicted" is the tax payer still on the hook for this imprudence? Conflict of Interest:None declared |
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Copyright 1995-2010, Canadian Medical Association. All rights reserved. ISSN 1488-2329
(e) 0820-3946 (p)
All editorial matter in CMAJ represents the opinions of the authors and not necessarily those of the Canadian Medical Association. |
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