Lawinenmedizin – Update 2015: Neue Erkenntnisse verlangen neue Strategien

Zusammenfassung

Der Lawinennotfall ist ein Sonderfall in der alpinen Notfallmedizin. Während die Prognose von unverletzten Patienten mit schwerer akzidenteller Hypothermie in der Regel günstig ist, hängt diese beim Lawinenverschütteten in erster Linie vom Schweregrad der Asphyxie und von traumatischen Verletzungen ab. Nur in seltenen Fällen können unterkühlte Lawinenverschüttete mit Kreislaufstillstand erfolgreich reanimiert und wiedererwärmt werden. Voraussetzung für einen erfolgreichen Lawineneinsatz sind Grundkenntnisse der Pathophysiologie und Einhaltung der Empfehlungen zur Triage von Lawinenopfern mit Herz-Kreislauf-Stillstand. Ziel des Lawineneinsatzes ist es, Verschüttete mit einer Chance auf erfolgreiche Reanimation bereits am Unfallort zu erkennen und die Rettungskette zur erfolgreichen Wiedererwärmung in einem geeigneten Krankenhaus fortzusetzen. Im folgenden Artikel werden Grundlagen der Pathophysiologie und Therapie nach den neuen ERC-Leitlinien zur kardiopulmonalen Reanimation beschrieben.

Abstract

An avalanche emergency is a special case in the field of alpine emergency medicine. While the prognosis of uninjured patients with severe accidental hypothermia is in general favorable, the outcome of avalanche victims depends primarily on the severity of asphyxia and traumatic injuries. The probability of successful resuscitation and rewarming of avalanche victims in cardiac arrest is very low. Rescuers should have basic knowledge of the pathophysiology and guidelines on management of avalanche victims in cardiac arrest. Buried patients with a chance of successful resuscitation should be identified already at the scene and the rescue chain should proceed to successful rewarming in a suitable hospital. In the following article, basics of the pathophysiology and therapy of avalanche victims in accordance with the new ERC resuscitation guidelines are described.

Schlüsselwörter

Lawine - Herz-Kreislauf-Stillstand - Reanimation - ERC Leitlinien

Keywords

avalanche - cardiac arrest - resuscitation - ERC guidelines

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