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. 2018 Jun;19(2):131-140.
doi: 10.1089/ham.2017.0143. Epub 2018 Feb 15.

Management of Multi-Casualty Incidents in Mountain Rescue: Evidence-Based Guidelines of the International Commission for Mountain Emergency Medicine (ICAR MEDCOM)

Marc Blancher  1   2 , François Albasini  2   3 , Fidel Elsensohn  4 , Ken Zafren  4   5   6 , Natalie Hölzl  7 , Kyle McLaughlin  8   9 , Albert R Wheeler 3rd  10   11 , Steven Roy  12 , Hermann Brugger  13 , Mike Greene  14 , Peter Paal  15
Affiliations

Management of Multi-Casualty Incidents in Mountain Rescue: Evidence-Based Guidelines of the International Commission for Mountain Emergency Medicine (ICAR MEDCOM)

Marc Blancher et al. High Alt Med Biol. 2018 Jun.

Abstract

Blancher, Marc, François Albasini, Fidel Elsensohn, Ken Zafren, Natalie Hölzl, Kyle McLaughlin, Albert R. Wheeler III, Steven Roy, Hermann Brugger, Mike Greene, and Peter Paal. Management of multi-casualty incidents in mountain rescue: Evidence-based guidelines of the International Commission for Mountain Emergency Medicine (ICAR MEDCOM). High Alt Med Biol. 19:131-140, 2018.

Introduction: Multi-Casualty Incidents (MCI) occur in mountain areas. Little is known about the incidence and character of such events, and the kind of rescue response. Therefore, the International Commission for Mountain Emergency Medicine (ICAR MEDCOM) set out to provide recommendations for the management of MCI in mountain areas.

Materials and methods: Details of MCI occurring in mountain areas related to mountaineering activities and involving organized mountain rescue were collected. A literature search using (1) PubMed, (2) national mountain rescue registries, and (3) lay press articles on the internet was performed. The results were analyzed with respect to specific aspects of mountain rescue.

Results: We identified 198 MCIs that have occurred in mountain areas since 1956: 137 avalanches, 38 ski lift accidents, and 23 other events, including lightning injuries, landslides, volcanic eruptions, lost groups of people, and water-related accidents.

Discussion: General knowledge on MCI management is required. Due to specific aspects of triage and management, the approach to MCIs may differ between those in mountain areas and those in urban settings.

Conclusions: Mountain rescue teams should be prepared to manage MCIs. Knowledge should be reviewed and training performed regularly. Cooperation between terrestrial rescue services, avalanche safety authorities, and helicopter crews is critical to successful management of MCIs in mountain areas.

Keywords: avalanche; emergency medicine; lightning; mountain rescue; multi-casualty incidents; wilderness medicine.

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Conflict of interest statement

No competing financial interests exist.

Figures

<b>FIG. 1.</b>
FIG. 1.
Flow Chart. *Reasons for first exclusion. (1) New research with exclusion criteria « crime » (n = 1474). (2) Articles “out of topic” (n = 354). **Reasons for second exclusion. (1) Articles related only to burn injury. (2) Articles related only to in-hospital management. (3) Urban-related MCI case reports (nonwilderness environment). (4) “Point-of-view” articles. MCI, multi-casualty incidents.
<b>FIG. 2.</b>
FIG. 2.
Example of a dedicated triage card. With authorization from Tanit® company.
See this image and copyright information in PMC

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