Climate change and human health in Alpine environments: an interdisciplinary impact chain approach understanding today's risks to address tomorrow's challenges.

The European Alps, home to a blend of permanent residents and millions of annual tourists, are found to be particularly sensitive to climate change. This article employs the impact chain concept to explore the interplay between climate change and health in Alpine areas, offering an interdisciplinary assessment of current and future health consequences and potential adaptation strategies.Rising temperatures, shifting precipitation patterns and increasing extreme weather events have profound implications for the Alpine regions.

Cardiorespiratory Responses to Exercise in Hypobaric versus Normobaric Hypoxia: A Randomized, Single-Blind, Crossover Study.

Purpose: There is controversy whether there are meaningful physiological differences between hypobaric (HH) and normobaric hypoxia (NH). This study aimed to compare the cardiorespiratory responses to acute HH and NH under strictly controlled conditions. We hypothesized no differences at rest and during submaximal exercise, whereas during maximal exercise, a higher maximal ventilation (V̇Emax), peripheral oxygen saturation (SpO2) and maximal oxygen consumption (V̇O2max) in HH than in NH.

Avalanche Survival Rates in Switzerland, 1981-2020.

Importance: Survival probability among individuals critically buried by avalanche is highly time dependent, which was demonstrated 30 years ago. However, it remains unclear whether avalanche survival probability has changed over time.

Objective: To assess the avalanche survival rate and probability as well as the rescue probability over the past 4 decades.

Drones reduce the time to defibrillation in a highly visited non-urban area: A randomized simulation-based trial.

Introduction: Out-of-hospital cardiac arrest (OHCA) has a high global incidence and mortality rate, with early defibrillation significantly improving survival. Our aim was to assess the feasibility of autonomous drone delivery of automated external defibrillators (AED) in a non-urban area with physical barriers and compare the time to defibrillate (TTD) with bystander retrieval from a public access defibrillator (PAD) point and helicopter emergency medical services (HEMS) physician performed defibrillation.

Methods: This randomized simulation-based trial with a cross-over design included bystanders performing AED retrievals either delivered by automated drone flight or on foot from a PAD point, and simulated HEMS interventions.

Vital parameter monitoring in harsh environment by the MedSENS in-ear multisensor device.

Accurate assessment of vital parameters is essential for diagnosis and triage of critically ill patients, but not always feasible in out-of-hospital settings due to the lack of suitable devices. We performed an extensive validation of a novel prototype in-ear device, which was proposed for the non-invasive, combined measurement of core body temperature (Tc), oxygen saturation (SpO), and heart rate (HR) in harsh environments. A pilot study with randomized controlled design was conducted in the terraXcube environmental chamber.

Effect of oxygen supplementation on cognitive performance among HEMS providers after acute exposure to altitude: the HEMS II randomized clinical trial.

Importance: Emergency medical services (EMS) providers transiently ascend to high altitude for primary missions and secondary transports in mountainous areas in helicopters that are unpressurised and do not have facilities for oxygen supplementation. The decrease in cerebral oxygen saturation can lead to impairment in attention and reaction time as well as in quality of care during acute exposure to altitude.

Objective: The primary aim of the current study was to investigate the effect of oxygen supplementation on cognitive performance in Helicopter EMS (HEMS) providers during acute exposure to altitude.

Avalanche burial pathophysiology - a unique combination of hypoxia, hypercapnia and hypothermia.

For often unclear reasons, the survival times of critically buried avalanche victims vary widely from minutes to hours. Individuals can survive and sustain organ function if they can breathe under the snow and maintain sufficient delivery of oxygen and efflux of carbon dioxide. We review the physiological responses of humans to critical avalanche burial, a model which shares similarities and differences with apnoea and accidental hypothermia.

Cerebral blood flow regulation in hypobaric hypoxia: role of haemoconcentration.

During acute hypoxic exposure, cerebral blood flow (CBF) increases to compensate for the reduced arterial oxygen content (CaO). Nevertheless, as exposure extends, both CaO and CBF progressively normalize. Haemoconcentration is the primary mechanism underlying the CaO restoration and may therefore explain, at least in part, the CBF normalization.

Prevalence of airway patency and air pocket in critically buried avalanche victims - a scoping review.

Introduction: Survival of critically buried avalanche victims is directly dependent on the patency of the airway and the victims' ability to breathe. While guidelines and avalanche research have consistently emphasized on the importance of airway patency, there is a notable lack of evidence regarding its prevalence.

Objective: The aim of this review is to provide insight into the prevalence of airway patency and air pocket in critically buried avalanche victims.

A revision of maximal oxygen consumption and exercise capacity at altitude 70 years after the first climb of Mount Everest.

On the 70th anniversary of the first climb of Mount Everest by Edmund Hillary and Tensing Norgay, we discuss the physiological bases of climbing Everest with or without supplementary oxygen. After summarizing the data of the 1953 expedition and the effects of oxygen administration, we analyse the reasons why Reinhold Messner and Peter Habeler succeeded without supplementary oxygen in 1978. The consequences of this climb for physiology are briefly discussed.

Frostbite treatment: a systematic review with meta-analyses.

Introduction: Our objective was to perform a systematic review of the outcomes of various frostbite treatments to determine which treatments are effective. We also planned to perform meta-analyses of the outcomes of individual treatments for which suitable data were available.

Main Body: We performed a systematic review and meta-analyses in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses.

Shoulder reduction on the scene: current practice and outcome of the Bavarian Mountain Rescue Service-a prospective observational study.

Out-of-hospital reduction of shoulder dislocations using the Campell method is recommended by the International Commission for Alpine Rescue and applied in the Bavarian Mountain Rescue Service (Bergwacht Bayern, BWB) protocols. This prospective observational study includes patients out-of-hospital with suspected shoulder dislocation and treated and evacuated by the BWB. Data were systematically collected using three questionnaires: one completed on-site by the rescuer, the second in hospital by the physician and the third within 28 (8-143) days after the accident by the patient.

Wilderness Medical Society Clinical Practice Guidelines for Prevention and Management of Avalanche and Nonavalanche Snow Burial Accidents: 2024 Update.

To provide guidance to the general public, clinicians, and avalanche professionals about best practices, the Wilderness Medical Society convened an expert panel to revise the evidence-based guidelines for the prevention, rescue, and resuscitation of avalanche and nonavalanche snow burial victims. The original panel authored the Wilderness Medical Society Practice Guidelines for Prevention and Management of Avalanche and Nonavalanche Snow Burial Accidents in 2017. A second panel was convened to update these guidelines and make recommendations based on quality of supporting evidence.

Auditory function in humans at high altitude. A scoping review.

Purpose: High-altitude (HA) affects sensory organ response, but its effects on the inner ear are not fully understood. The present scoping review aimed to collect the available evidence about HA effects on the inner ear with focus on auditory function.

Methods: The scoping review was conducted following the guidelines of the Preferred Reporting Items for Systematic Review and Meta-Analysis extension for scoping reviews.

Sudden-Onset Disaster Mass-Casualty Incident Response: A Modified Delphi Study on Triage, Prehospital Life Support, and Processes.

The application and provision of prehospital care in disasters and mass-casualty incident response in Europe is currently being explored for opportunities to improve practice. The objective of this translational science study was to align common principles of approach and action and to identify how technology can assist and enhance response. To achieve this objective, the application of a modified Delphi methodology study based on statements derived from key findings of a scoping review was undertaken.

Isolated high altitude psychosis, delirium at high altitude, and high altitude cerebral edema: are these diagnoses valid?

Psychosis is a psychopathological syndrome that can be triggered or caused by exposure to high altitude (HA). Psychosis can occur alone as isolated HA psychosis or can be associated with other mental and often also somatic symptoms as a feature of delirium. Psychosis can also occur as a symptom of high altitude cerebral edema (HACE), a life-threatening condition.