The Latest Avalanche Review

December 1, 2018
By Jessica Duke, MD

The winter backcountry season has officially begun. Before you head out to shred some gnar, it is essential to have an understanding of how people get injured in avalanche accidents and what you can do to help yourself or someone else caught in an avalanche. Let’s review the latest article on avalanche fatalities from the September 2018 Wilderness & Environmental Medicine journal:

Causes of Death Among Avalanche Fatalities in Colorado: A 21-Year Review

Alison Sheets MD, Dale Wang MD, Spencer Logan, Dale Atkins

The authors reviewed all avalanche fatalities from 1994 to 2015 in the state of Colorado. Mortality information was available for 110 out of 121 fatalities during this 21-year period. Asphyxia was the most common cause of death in these fatalities (65%, 72/110), followed by trauma (29%, 32/110). Head injury was the primary injury in nearly one third of the traumatic fatalities (31%, 10/32). The remaining causes of death included hypothermia, drowning, and primary cardiac arrest (6/110). 

These findings are similar to Canadian avalanche studies, but the trauma rate is notably higher compared to previous studies in Europe and Utah. These differences have previously been attributed to geography, topography, season, and activity. However, the incidence of deadly trauma in this study did not correlate with the victim’s activity or mode of travel, the avalanche type, or the starting zone elevation.

So what can we take away from this avalanche study? Well, we learned that the most common causes of death in avalanche accidents in Colorado are asphyxia and trauma. Of course, prevention is the most important action to ensure survival in avalanche terrain (see tips below), but we can potentially save lives with rapid rescue and appropriate resuscitation of avalanche victims. Avalanche victims can be saved from asphyxia with the proper equipment and rescue techniques to reduce burial time. These include airbags deployed by the victim to stay on top of the snow, transceivers used by the rescuers to locate a buried victim quickly, and probing/shoveling techniques to rapidly dig out an avalanche victim. These skills can be acquired and practiced through an avalanche course. Trauma prevention and management in the on-site care of avalanche victims can help save lives from traumatic injuries. Backcountry enthusiasts should wear protective equipment such as helmets to mitigate the severity of injury and rescuers should have appropriate first aid training.

You now have a better understanding of avalanche injuries and how you can help yourself and others caught in an avalanche. Have fun out there and stay safe by following these avalanche safety tips:

  • Take an avalanche and first aid course.
  • Check the forecast to assess snowpack and avalanche conditions. Avalanche forecasts can be found at in the United States.
  • Make sure everyone in your group is carrying a beacon (with fresh batteries), shovel, and probe. 
  • Wear a helmet and a backpack with an airbag.
  • Expose only one person at a time in avalanche terrain.
  • Avoid slopes between 30-45 degrees, especially if there are thick slabs of wind-drifted snow or collapsing/cracking snow.
  • Avoid terrain traps such as gullies, flat transitions, and creeks.
  • Don’t be afraid to speak up if you are concerned.

To access the article, go to


Jessica Walrath, MD, FAWM, DiMM
Graduate of the Yale Wilderness Medicine Fellowship