Avalanche Airflow Device may Delay Life-Threatening Hypoxemia, extend survival in Simulations: JAMA

A new study published in the Journal of the American Medical Association revealed that during simulated full burial conditions, a user-carried avalanche safety device that channels air from surrounding debris to the victim's airways without additional oxygen significantly delayed the onset of dangerous hypoxemia and hypercapnia, suggesting potential to extend survival time in actual avalanche emergencies.

People who are severely buried by an avalanche usually pass away from suffocation within 35 minutes, which frequently prevents prompt rescue. To increase survival rates, new techniques for postponing asphyxiation must be developed. Thus, this study examined the effectiveness of a new user-carried avalanche safety gear that provides airflow from avalanche debris to the user's airway without the need for additional oxygen or a mouthpiece.

4 universities coordinated this clinical study, which took place at one field site in Italy from January to March of 2023. Volunteers in good health between the ages of 18 and 60 were recruited and were placed in a prone posture with at least 50 cm of snow covering them during a critical snow burial scenario.

Throughout the simulation, vital metrics were constantly tracked to gather physiological data and guarantee participant safety. Randomization was used to assign participants to either the control group (using a sham device) or the safety device group (using the Safeback SBX device). Participants in the safety device group who were still buried after 35 minutes were smoothly moved to the sham device as part of an unblinded control.

24 of the 36 randomly selected individuals participated in the experiment, finished it, and were included in the final analysis. 13 (54%) of them were men, and the median (IQR) age was 27 (25-32). The control group had seven events and a median (IQR) burial time of 6.4 (4.8-13.5) minutes, whereas the safety device group had a median (IQR) burial duration of 35.0 (35.0-35.0) minutes and no incidents.

The chance of termination owing to Spo2 less than 80% was much lower in the safety device group. Carbon dioxide in the air pocket was 1.3% (95% CI, 1.0%-1.6%) versus 6.1% (95% CI, 5.1%-7.1%) and oxygen was 19.8% (95% CI, 19.5%-20.1%) vs 12.4% (95% CI, 11.2%-13.5%) at the same times in the safety device and control groups, respectively.

Overall, a user-carried avalanche safety system that directs airflow from avalanche debris into the user's airways without the need for supplementary oxygen delaying severe hypoxemia and hypercapnia during simulated critical burial.

Reference:

Eisendle, F., Roveri, G., Rauch, S., Thomassen, Ø., Dal Cappello, T., Assmus, J., Malacrida, S., Kammerer, T., Schweizer, J., Borasio, N., Dörck, V., Falk, M., Falla, M., Fruzzetti, N., Maxenti, M., Mydske, S., Sasso, G. M., Vinetti, G., Wallner, B., … Strapazzon, G. (2025). Respiratory gas shifts to delay asphyxiation in critical avalanche burial: A randomized clinical trial: A randomized clinical trial. JAMA: The Journal of the American Medical Association, 334(19), 1720. https://doi.org/10.1001/jama.2025.16837