Avalanche fatality in Tuckerman's Ravine

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I saw pictures of the avalanche aftermath on ski_the_whites Instagram page. It occurred in Raymond Cataract.
 
Pardon my pickiness, but it occurred in the Ravine of Raymond Cataract. Raymond Cataract is the name of the series of four waterfalls—which consolidate into two in winter, according to the 1966 AMC White Mountain Guide—below the upper snowfield-like portion of the ravine. I'm not sure, but from what I could tell from the Mount Washington Avalanche Center's Instagram post, it seems like the avalanche started just above the highest of the two winter cataracts and settled either between the two or below the second.
 
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I will gladly let a moderate edit the title. Initial reports listed it as Tuckermans ravine. Note many of the stock video images shown on various new stations have been of locations not in Raymond Cataract.

There was also a news article yesterday regarding building a new AMC helicopter area at Pinkham Notch. Turned out the actual location is off the base station road on the other side of the mountain from Pinkham.
 
It's a real challenge in the outdoor scenario. The goal is to warm the core, but not to warm the extremities too rapidly. If the extremities are warmed too rapidly, restored circulation brings blood from the extremities to the core. Two problems result: "Afterdrop" - the return of cold blood from the extremities causes the core temperature to drop; toxicity - if the extremities have been without circulation long enough, the blood that is there is deoxygenated and also high in metabolic waste products. Delivering that too quickly to the core can have toxic effects. So that's why you should warm the core first.

But it's hard to do standing in a snow pile - you have to do the best you can with hot packs strategically located, etc.

And of course we can't be sure that either of these phenomena were what actually created the problems for this particular victim...
 
It's a real challenge in the outdoor scenario. The goal is to warm the core, but not to warm the extremities too rapidly...

Looking at the avalanche track and the fact he was swept over a waterfall, I think it's likely that he suffered internal injuries as well as hypothermia.

A tragic story amplified by the fact he survived burial only to die during the extrication. But in the end, his beacon worked just as it was designed to.

And the instincts of his rescuer were absolutely correct in believing there was a problem that needed checking into. Major kudos to him.

cb
 
A really enthralling read. I haven't read one in so much detail previously; only read one with similar drama previously which was in Gulf of Slides quite a long time ago (which we were nearly in).

What struck me is he was obviously experienced, knew the risks, had the proper gear and appeared to know what he was doing. Being alone may or may not have mattered (likely it would've helped, but not guaranteed). Otherwise, as noted in the report, what he did is done by many all over and it's without issue.

I wouldn't be skiing terrain like that due to my skill-level, but I can look back at a few instances and can relate to it.
 
This scenario is really tough, being in the snow pile in remote terrain. Is it always best to start warming the core immediately, or are there cases when one should leave the victim 'cold' until the logistics for rewarming/transport can be worked out (if even possible)? I.E., does moving them start a countdown to needing advanced life support systems to survive?

I don't think I'm qualified to try to answer that. Ski Patroller and EMT-Basic here. Maybe someone who's an ER Doc or Wilderness Paramedic wants to chime in?
 
If you haven't seen it, here is a detailed first-hand account of a partial burial in Oakes Gulf on the same day. I thought it a worthwhile read, especially in light of what happened in Raymond Cataract.
 
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