Mountain rescue medicine in the Mont Blanc Massif: 3932 accidents in 8 years.

Abstract

More than 500 rescues are made each year from the mountains of the Mont-Blanc Massif and in more than 60% of these rescues a doctor is present at the scene. The rapid transmission of the alert thanks to a sophisticated radio network, the relatively compact size of the Mont-Blanc Massif and the ideal position of the Hospital de Chamonix mean that almost all rescues are completed in less than an hour. The helicopters winch allows rescues to be carried out in the most inaccessible and perilous places. During high season (seven months of the year) a doctor is pemanently on-call at the heli-pad, ready to join the rescue team at a moment's notice. To be an effective member of the team the doctors must not only be competent in traumatology and emergency medicine but also be strong and experienced mountasineers. The medical equipment carried is robust, ligth and compact enough to be carried in a rucksack. The rescue victims are predominantely young, male and are often foreign 15% of patients are severely injured and 7% are pronunced dead at the scene. Long-term follow up of the severely injured patients shows that 83% go on to make a good recovery and that their prognosis is better if the time between accident and medical attention is short. The most common pathology seen is a moderately severe, traumatic injury of the lower limn. Immobilisation, sedation and analgesia prove the basis of treatment in the mountains. More worrying are injuries to the head or spine and ischaemic heart disease. Hypothermia is often a consequence of other injuries or illness. Medical treatment in hostile mountain conditions must be kept to a minimun. The experience of the docto is essential as it is he who must find the best compromise between medical treatment at the scene and immediate evacuation so removing the victim from the effects of cold, hypoxia and objective danger (avalanche, stone-fall etc.) If the weather is mild or if immediate evacuation is difficult, all the usual resuscitation techniques are possible. Finally, the role of prevention remains essential.