Hoisting a paramedic beat an underslung antenna in Norwegian helicopter avalanche search trial

A randomized field trial published in Prehospital and Disaster Medicine and listed in PubMed on November 6, 2026, found that hoisting a rescue paramedic with a handheld transceiver located a buried avalanche beacon faster than an underslung antenna flown beneath the helicopter ^[1]. The total time to find the transceiver differed by 143 seconds between the two methods, with a 95% confidence interval of 113 to 172 seconds and P <0.001 ^[1].

The study was run by the on-duty crew of the Norwegian Search-and-Rescue helicopter at Ørland Main Airforce Base in Trøndelag, Norway ^[1]. The authors, led by Brede JR, compared the two procedures that the Norwegian service already uses as standard ^[1]. According to the full text, the 330 Squadron of the Norwegian Air Force operates six out of seven SAR helicopter bases on the Norwegian mainland and had no formal comparison of the two methods before this trial ^[2].

The authors wrote that the hoist method cut localization time "by more than two minutes" and that, because survival falls after 10-15 minutes of burial, the saving "may be clinically significant" ^[1].

What the records show

The trial was set up in a decommissioned alpine ski area near the helicopter base ^[2]. Crews packed a simulated avalanche area of 80 × 150 meters by ski and foot and marked its borders ^[2]. Six transceivers were buried at a depth of approximately 0.5m ^[1]. The six locations stayed fixed for all runs and were known only to the principal investigator and two ground assistants, while only one transceiver was switched on per run and the choice was randomized to stop the crew from memorizing positions ^[1][2]. The order of which search method to use was also randomized ^[1].

Four timestamps were recorded on each run: First Signal, Optimal Signal, RP on Ground, and Transceiver Found ^[1]. Over three days the crew completed 25 runs, 13 with the antenna search and 12 with the rescue paramedic hoist search ^[1].

The abstract also states that the hoist method produced a significantly faster fine search on the ground, though the packet gives no figure for that step ^[1].

The aircraft was a Leonardo AW101 with a six-person crew: two pilots, a system operator, a flight engineer who runs the hoist, a rescue paramedic, and a consultant anesthesiologist ^[2]. Both procedures use the aircraft's electrical rescue hoist, a Breeze-Eastern HS-29900-66 with a maximum workload of 272kg and a maximum wire length of 88m, or 290 feet ^[2]. The buried beacons were EasySearcher 4 units made by Manuel Genswein in Switzerland ^[2]. Under the squadron's normal procedure, the paramedic stays attached to the cable when there is a secondary avalanche risk and unhooks when the area is judged stable; in this study the paramedic unhooked in all runs ^[2]. One crew performed every run, the exercise was conducted as standard training, and the pilot in command completed a risk assessment first ^[2].

Why it matters for EMS

The study speaks directly to helicopter crews who can be the first asset to locate a buried person when companion rescue has not already done so, when the debris field is too large or dangerous for ground teams, or when the victim was alone ^[2]. The authors wrote that helicopters are often sent to avalanches because burial is time-critical, sites are remote, and severe trauma is common ^[1].

The time differences are measured in seconds, but the authors tie them to a survival curve that drops steeply after 10-15 minutes of burial ^[2]. The full text notes that the median burial depth for patients with an air pocket is 60cm and for all buried patients is 100cm, so the 0.5m test depth sits at the shallow end of real incidents ^[2].

The authors concluded that the hoist method is "an effective localization strategy for SAR helicopter services with comparable hoist systems" ^[1]. Crews follow their own protocols and medical direction.

Context

International guidelines for avalanche prevention, rescue, and clinical care have existed since 1996 and are updated regularly, according to the full text ^[2]. In Northern Europe, avalanches account for more than 100 deaths per year ^[2]. In Norway, 806 people were caught in snow avalanches over the last decade, with 127 injuries and 57 deaths, most triggered by skiers or recreational users ^[2]. A Norwegian retrospective study covering 1996 to 2017 found that approximately 30% of those caught were rescued by companions, 35% self-rescued, and 35% waited for organized rescue ^[2].

The full text describes a typical skier-triggered avalanche as Size 2 or Size 3 on the European scale, with a slab about 50–80m wide, 150m long, and 50cm thick, or roughly 400 tons of snow ^[2].

What the records do not tell us

• No real victims were involved. The trial measured time to find a transceiver, not survival or patient outcome ^[1].
• All beacons were buried at approximately 0.5m. The authors state the depth was chosen for reproducibility and does not represent the full range of real burials ^[2].
• A single crew on a single aircraft type performed all 25 runs; the records do not say how the method performs with other crews, aircraft, or hoists ^[2].
• The packet does not report absolute times for each method, only the differences between them, and gives no numbers for the fine search finding ^[1].
• The test slope had no trees or large rocks inside its borders; the records do not describe performance in cluttered terrain ^[2].
• The available full text is truncated and does not include the results or discussion sections, funding, or declared conflicts of interest.
• No US data appear in the packet, and the records do not say whether any US air medical or SAR program uses either procedure.

What to watch

The records do not name a follow-up study, protocol change, or guideline revision tied to these findings.

This is news, not medical advice. EMS clinicians: follow your local protocols and medical direction.