People who are critically buried by an avalanche often die of asphyxia within minutes, making timely rescue challenging. In a new study published in JAMA, Eisendle, Roveri, Rauch, and colleagues investigated the efficacy of a novel, user-carried avalanche safety device designed to deliver airflow from snow debris directly to the user’s airway without the need for supplemental oxygen or a mouthpiece. The authors report that the device significantly prolonged safe breathing time during simulated avalanche burial, effectively delaying critical hypoxemia and hypercapnia compared with a sham device.
The randomized, blinded clinical trial was conducted at a field site in Italy from January to March 2023, enrolling healthy volunteers aged 18 to 60 years. Participants were buried in a prone position under at least 50 centimeters of snow, simulating critical avalanche conditions. The trial randomized participants to use either the Safeback SBX airflow device or a sham device. Vital parameters, including oxygen saturation and carbon dioxide levels, were continuously monitored throughout the simulation. The primary outcome was time to oxygen saturation below 80 percent, while secondary outcomes included oxygen and carbon dioxide concentrations at various distances within the snow. Of 36 randomized participants, 24 completed the trial and were included in the final analysis.
The results demonstrated that participants using the safety device maintained oxygen saturation above 80 percent for the full 35-minute monitoring period, whereas the control group reached critical hypoxemia within a median of 6.4 minutes, with seven participants experiencing oxygen desaturation events. Measurements from the snow air pockets showed that the device maintained oxygen concentrations near normal levels and dramatically reduced carbon dioxide accumulation compared with the control condition. These findings indicate that the device provides a micro-environment of sustained ventilation, extending the period during which survivors can breathe safely under snow. The authors conclude that incorporating such user-carried airflow systems into avalanche safety protocols could meaningfully improve survival in critical burial scenarios, though further research in real-world settings is warranted.
Reference:
Eisendle F, Roveri G, Rauch S, et al. Respiratory Gas Shifts to Delay Asphyxiation in Critical Avalanche Burial: A Randomized Clinical Trial. JAMA. Published online October 8, 2025. doi:10.1001/jama.2025.16837
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