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Scot: Avalanche danger super high across the entire state of Utah. Unfortunately a couple people have already died because of avalanches. We're with Dr. Troy Madsen, Emergency Medicine at Utah Hospital. Have you ever seen avalanche victims come into the ER?

Dr. Madsen: I have. I have seen avalanche victims come into the ER. Sometimes these are patients who have been transported. In some cases-I haven't cared for them personally-but I've heard of cases where they have just been basically had no heartbeat but they continue to work on them to try and get them back, and brought them to the ER, transporting them from the mountains. I've seen patients who have come in who have had multiple injuries those types of things. So kind of the full range of avalanche victims have come into the emergency department.

Scot: So I would have thought if somebody had died because of an avalanche they'd just say well, "They're dead," but they bring them to the ER.

Dr. Madsen: They will, and the reason they'll work on them, and continue to try and treat them for longer than, say, a victim of a motor vehicle accident is because if you're in an avalanche you're often under the snow for a prolonged period of time. If they don't have a pulse on that person that person is also hypothermic, their body is very cold, and being very cold can preserve the brain function, and sometimes help us get that person back, where if the average person had had a heart attack and was down for 30 minutes, the likelihood of getting that person back, and having any kind of a good outcome is very low.
So avalanche victims it's a little bit different in that sense where they may have been very cold and that can kind of preserve things so they may continue to work on those patients longer than we would otherwise.

Scot: Really? So there's a better chance you could resuscitate them?

Dr. Madsen: Yeah, potentially. Yeah.

Scot: And have a good recovery?

Dr. Madsen: Yeah. It's kind of like drowning in cold water, we think of it the same way. Being in that just really cold temperature, that's kind of like preserving meat in a freezer in a sense.

Scot: Sure. I guess that makes sense, but I never realized that was actually fact. That's interesting.

Dr. Madsen: It really does work, and you know it's interesting too if we do CPR on a patient and we get them back, we cool their body down at that point to try and preserve them and kind of preserve their brain function, and we've shown it helps them to have a better outcome.

Scot: Interesting. All right. So let's talk about avalanche danger in general. What are some of the things people should be aware of?

Dr. Madsen: Yeah. I think the number one thing to be aware of right now is the avalanche danger is extremely high, and I'll preface this by saying I'm not an avalanche exper.t I'm an ER doctor who's cared for the consequences of avalanches, and I would kind of casually like to go in the outdoors, and in the back country. But keep in mind the danger is extremely high, and we're not talking about people going up you know high in the back country, on back country skis. We're talking about people snowshoeing next to the road. This person who died, American Fort Canyon, from what I can tell was pretty close to the road in what may seem a very tame area.

Scot: Wow. Because my wife and I joke about that, we snow shoe and we're like, "Oh, the avalanche, that's not going to affect us."

Dr. Madsen: And that was my thought too. You know you think, "I'm in my neighborhood. I'm just in the foothills," or, "I'm just up in the mountains, I'm not high up at 10,000 feet." This was not at 10,000 feet. Avalanches can happen on any slope, but classically they say 30 degrees or more. And it's always tough for us to tell what's exactly is 30 degrees. But we're talking about a decent slope there but not a real steep slope. So you could be anywhere in the backcountry, hiking, snow shoeing, just getting out, certainly snowmobiling, these sorts of things.
It is just an incredibly high risk right now, and if there's any advice I would give it would be to always go to the Utah Avalanche website, UtahAvalanche.org. They're going to have all of the ratings for the risk, and right now it's approaching extreme. It's very high right now, and if that's the case it's just best to avoid the backcountry because of the risk there.

Scot: All right. Let's talk about somebody does go out into the backcountry. An avalanche happens, I'm not buried but somebody that I'm with is. What do I do at that point?

Dr. Madsen: Well, first of all, at that point it's you're in a tough situation. I think that's the bottom line. The teaching I've had, and learned . . . and there's a great book if you ever go in the backcountry. You should read it. It's called Surviving an Avalanche Training is the title of it, I think. But it talks about how the best thing to avoid is certainly being in an avalanche in the first place. Because when you're in an avalanche, 25% of the time you're going to get killed just by the trauma, just by rocks, boulders, that sort of thing.
So then there's a 75% chance you're going to be buried under the snow. If you're under the snow you're not going to be able to dig yourself out. It's like being encased in concrete. You can't move; you're stuck there. So if you're with someone where that happens, hopefully, first of all, you're wearing a beacon, and beacons are something you can get. They're a little expensive; you're looking at like a $150.00, but it's something where basically it's going to allow another person with a beacon to detect where you are.

Ideally, before you're in the backcountry you've used these things, you know how they work, but you're going to use your beacon to try to find where this person is. Again, trying to find a person that doesn't have a beacon on is extremely difficult. We're not talking about a small pile of snow this person's under. We're talking often times about a slope that's a 100, 200 feet wide, that has slid for 400 feet, and is covering someone somewhere underneath it.

Scot: Yeah.

Dr. Madsen: So ideally, you have a beacon. Hopefully, you know how to use it. Try and find the person. If you have a group, use that entire group. Typically you're going to have poles that you probe with to try and find where this person is and then start digging and try and get them out. But quite honestly, once someone is buried, yeah, you want to try and find them, but not a great situation.

Scot: Yeah just...Prevention truly is...

Dr. Madsen: Prevention, exactly.

Scot: Prevention is about as good as it...yeah

Dr. Madsen: Exactly. That's something to keep in mind too. I think a lot of times we feel safe because maybe we've gotten a beacon, and we've practiced a little bit with it so we're like, "Let's head in the back country. Yeah the avalanche risk is high." Keep in mind that beacon is not going to save your life. You really should travel as if you don't have a beacon, and then that beacon is there. Maybe there is a slight chance someone might be able to dig you out, and maybe once they dig you out you might survive, but travel as if you don't have a beacon.

Scot: All right. Any final thoughts? I can predict what you're going to say.

Dr. Madsen: Yeah. I mean, my final thought is watch the avalanche risk. Keep an eye on UtahAvalanche.org. If you're ever heading out anywhere that has a slope-if you're going cross country skiing, snow shoeing, back country skiing, snowmobiling, whatever it is-and if that avalanche risk is elevated don't go. Just avoid the backcountry. Just avoid the risk of the avalanches.

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