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Avalanche burial — DipIMC MCQ

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HardEnvironmental MedicineAvalanche burialDipIMC

A skier is extricated after 35 minutes under avalanche debris. The airway was packed with snow and he is pulseless and very cold. What is the most appropriate management?

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Correct answer: AStart resuscitation, prevent heat loss and consider hypothermic arrest pathway

Start resuscitation, prevent heat loss and consider hypothermic arrest pathway is the best answer because avalanche arrest may involve asphyxia and hypothermia, requiring resuscitation and destination decisions. Defer treatment until a senior hospital doctor reviews the patient is less appropriate because pre-hospital clinicians must treat immediate threats within scope; Give unrestricted crystalloid to normalise blood pressure is less appropriate because over-resuscitation can worsen bleeding when haemorrhage is uncontrolled. Provide reassurance and reassess after transport and Use oral analgesia as the main treatment are also suboptimal because they move attention away from the key pre-hospital priority.. The key DipIMC principle is to treat immediate reversible threats, communicate clearly and move the patient toward the right definitive care.

Reference: Resuscitation Council UK Guidelines; JRCALC Guidelines; ATACC Manual