Herz-Kreislauf-Stillstand im alpinen Gelände

ZUSAMMENFASSUNG

Die Anzahl von Touristen und Freizeitsportlern in Bergregionen nimmt zu. Im Verhältnis dazu steigt auch die Zahl an Notfallsituationen wie Herz-Kreislauf-Stillstand. Wiederbelebungsmaßnahmen in diesen Umgebungsbedingungen sind anspruchsvoll. Eine besondere Bedeutung in diesem Rahmen hat die prolongierte kardiopulmonale Reanimation.

ABSTRACT

The number of tourists and recreational athletes in alpine regions is rising. Thus, the number of emergency situations like cardiac arrests is also growing. Resuscitation in these circumstances is challenging. Prolonged cardiopulmonary resuscitation is of particular importance in this context.

Key words

avalanche - cardiac arrest - hypothermia - lightning - mountain medicine

• Literatur

• 1 Burtscher M, Ponchia A. The risk of cardiovascular events during leisure time activities at altitude. Prog Cardiovasc Dis 2010; 52: 507-511
• 2 Gatterer H, Niedermeier M, Pocecco E. et al Mortality in Different Mountain Sports Activities Primarily Practiced in the Summer Season-A Narrative Review. Int J Environ Res Public Health 2019; 16: 3920
• 3 Niedermeier M, Gatterer H, Pocecco E. et al Mortality in Different Mountain Sports Activities Primarily Practiced in the Winter Season – A Narrative Review. Int J Environ Res Public Health 2020; 17: 259
• 4 Lott C, Truhlář A, Alfonzo A. et al European Resuscitation Council Guidelines 2021: Cardiac arrest in special circumstances. Resuscitation 2021; 161: 152-219
• 5 Paal P, Pasquier M, Darocha T. et al Accidental Hypothermia: 2021 Update. Int J Environ Res Public Health 2022; 19: 501
• 6 Dow J, Giesbrecht GG, Danzl DF. et al Wilderness Medical Society Clinical Practice Guidelines for the Out-of-Hospital Evaluation and Treatment of Accidental Hypothermia: 2019 Update. Wilderness Environ Med 2019; 30 4S S47-S69
• 7 Durrer B, Brugger H, Syme D. The medical on-site treatment of hypothermia: ICAR-MEDCOM recommendation. High Alt Med Biol 2003; 04: 99-103
• 8 Mroczek T, Gladki M, Skalski J. Successful resuscitation from accidental hypothermia of 11.8°C: where is the lower bound for human beings?. Eur J Cardiothorac Surg 2020; 58: 1091-1092
• 9 Pasquier M, Zurron N, Weith B. et al Deep accidental hypothermia with core temperature below 24°c presenting with vital signs. High Alt Med Biol 2014; 15: 58-63
• 10 Strapazzon G, Procter E, Paal P. et al Pre-hospital core temperature measurement in accidental and therapeutic hypothermia. High Alt Med Biol 2014; 15: 104-111
• 11 Musi ME, Sheets A, Zafren K. et al Clinical staging of accidental hypothermia: The Revised Swiss System Recommendation of the International Commission for Mountain Emergency Medicine (ICAR MedCOM). Resuscitation 2021; 162: 182-187
• 12 Paal P, Lechner R, Wallner B. et al Akzidentelle Hypothermie. Allgemeine Plus 2022; 22 Februar 2022. Im Internet https://www.allgemeineplus.at/article/akzidentelle-hypothermie-124287
• 13 Daniel N, Weinberg N, Carus F. et al Witnessed Cardiac Arrest in a Hypothermic Avalanche Victim Completely Buried for 2 Hours. Wilderness Environ Med 2021; 32: 92-97
• 14 Schön CA, Gordon L, Hölz N. et al Determination of Death in Mountain Rescue: Recommendations of the International Commission for Mountain Emergency Medicine (ICAR MedCom). Wilderness Environ Med 2020; 31: 506-520
• 15 Podsiadlo P, Darocha T, Svendsen ØS. et al Outcomes of patients suffering unwitnessed hypothermic cardiac arrest rewarmed with extracorporeal life support: A systematic review. Artif Organs 2021; 45: 222-229
• 16 Pasquier M, Hugli O, Paal P. et al Hypothermia outcome predicition after extracorporeal life support for hypothermic cardiac arrest patients: The HOPE score. Resuscitation 2018; 126: 58-64
• 17 Boue Y, Payen JF, Brun J. et al Survival after avalanche-induced cardiac arrest. Resuscitation 2014; 90: 1192-1196
• 18 Moroder L, Mair B, Brugger H. et al Outcome of avalanche victims with out-of-hospital cardiac arrest. Resuscitation 2015; 89: 114-118
• 19 Rauch S, Strapazzon G, Brugger H. On-Site Medical Management of Avalanche Victims – A narrative Review. Int J Environ Res Public Health 2021; 18: 10234
• 20 Mair P, Frimmel C, Vergeiner G. et al Emergency medical helicoper operations for avalanche accidents. Resuscitation 2013; 84: 492-495
• 21 Brodmann Maeder M, Rauch S, Strapazzon G. et al Medizinische Aspekte bei Lawinenunfällen – ein Update. Flug u Reisemed 2017; 24: 221-225
• 22 Wallner B, Moroder L, Salcher H. et al CPR with restricted patient access using alternative rescuer positions: a randomised cross-over manikin study simulating the CPR scenario after avalanche burial. Scand J Trauma Resusc Emerg Med 2021; 29: 129
• 23 Verband der Elektrotechnik, Elektronik und Informationstechnik. 28.06. 2019 Statistik der Blitzunfälle mit Per-sonenschaden in Deutschland. Im Internet https://www.vde.com/resource/blob/1866066/47140ba603c40015abe56b861239029c/statistik-blitzunfaelle-bild-download-data.pdf
• 24 Ströhle M, Wallner B, Lanthaler M. et al Lightning accidents in the Austrian alps – a 10-year retrospective nationwide analysis. Scand J Trauma Resusc Emerg Med 2018; 26: 74
• 25 Bühren V, Keel M, Marzi I. et al Blitztrauma, Verletzung durch Blitzschlag. In: Bühren V, Keel M, Marzi I, Hrsg. Checkliste Traumatologie. 7. Aufl. Stuttgart: Thieme; 2011
• 26 Christophides T, Khan S, Ahmad M. et al Cardiac Effects of Lightning Strikes. Arrhythm Electrophysiol Rev 2017; 06: 114-117
• 27 Davis C, Engeln A, Johnson EL. et al Wilderness Medical Society practice guidelines for the prevention and treatment of lightning injuries: 2014 update. Wilderness Environ Med 2014; 25 (Suppl. 04) S86-S95
• 28 Truhlář A, Deakin CD, Soar J. et al European Resuscitation Council Guidelines for Resuscitation 2015: Section 4. Cardiac arrest in special circumstances. Resuscitation 2015; 95: 148-201
• 29 Deutsche Gesellschaft für Verbrennungsmedizin. S2k-Leitlinie Behandlung thermischer Verletzungen des Erwachsenen. Stand 1. Februar 2021. Im Internet https://www.awmf.org/uploads/tx_szleitlinien/044-001l_S2k_Behandlung-thermischer-Verletzungen-des-Erwachsenen_2021-07.pdf