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Globally recognised Rescue “Bible” now includes chapter on avalanches for the first time

New resuscitation guidelines from ILCOR: South Tyrol avalanche experts rewrite entire chapter on hypothermia

“Server overload!” was the message on October 18 on websites all over the world run by first aid and resuscitation organisations. And the reason for this massive surge in interest? The publication of the newly revised guidelines which the International Liaison Committee on Resuscitation (ILCOR) issues every five years.

These guidelines are provided for doctors, paramedics and first aiders worldwide. And for the first time ever, this “Bible of Reanimation” includes a chapter on the resuscitation of avalanche victims. The recommendations are based on the scientific findings of South Tyrol doctor Hermann Brugger who is in charge of the research institute for Alpine Emergency Medicine at the European Academy of Bozen / Bolzano, the only one of its kind in the world.

“Yet again, we were able to move things forward”, says Hermann Brugger, sitting in his office chair which, a whole year after the opening of the Institute for Alpine Emergency Medicine in Bozen / Bolzano, still shows no signs of wear and tear. His activities as an enthusiastic mountaineer, mountain rescue medic, general practitioner in his home town of Bruneck, lecturer at the University of Innsbruck and, last but not least, as the manager of his Institute, mean that he is always on the move.

He has just come back from attending this year’s annual meeting of the International Commission for Alpine Rescue (ICAR-CISA) which was held in Slovakia, where the EURAC Institute of Alpine Emergency Medicine was without much further ado accepted as an official member of ICAR and entrusted with the task of drawing up the scientific principles of Alpine Medicine for future international mountain rescue guidelines.

Brugger’s core areas include research into trauma caused by extreme low temperatures as well as the recovery and treatment of avalanche victims. In a pioneering study, carried out in collaboration with his Canadian colleague Jeff Boyd, he worked through the entire international research literature on avalanche medicine published since the 1970s. They systematically checked more than one thousand articles for factors contributing to the survival of avalanche victims. The results of this study served as the scientific basis for the chapter dealing with the resuscitation of avalanche victims which has now found its way into the guidelines of the International International Liaison Committee on Resuscitation (ILCOR).

The 230 pages long manual contains the ILCOR guidelines – practical guidelines for resuscitation based on standard international recommendations and a broad consensus, as well as on detailed scientific analysis. Every five years the latest scientific findings, translated into concrete, step-by-step instructions, are incorporated into the guidelines and published in a new edition. These instructions are mandatory for all doctors, rescue services, first aid instructors as well as first aiders without medical training.

The inclusion of new chapters is subject to the most rigorous selection criteria. Brugger remembers how, in the course of an Internet telephone conference on January 5th 2009, they were cross-examined by 40 ILCOR experts from all over the world, who challenged them on areas of ambiguity and subjected the results of the study to the closest possible scrutiny. In conclusion, the research results were accepted and made available for comment on the Internet for the period of one year, before being finally included in the present ILCOR guidelines.

In conjunction with Peter Paal, also from South Tyrol and a lecturer at the Innsbruck University Clinic, Brugger additionally rewrote the entire ILCOR chapter on hypothermia, in order to reflect the latest scientific findings in this area.

Laura Defranceschi | idw
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