Mountain Rescue and Wilderness Medicine

CTSA

Cardiovascular SummitMarch 4-6, 2016

Beaver Creek, Colorado

Skeet Glatterer, MD, FAWM

Mountain Rescue Association

• Group of highly trained volunteer professionals

• Oldest SAR organization in the US

• Collection of 100 teams with 2,500 members

• 8 regions:

– Rocky Mountain Region (CO, NM, WY) with 15 teams

– More than 5,000 SAR operations yearly

– Board of Directors – the teams

– Governed by 5 elected officers

MRA (www.MRA.org)

MRA - Qualifications

• Teams confirmed as members after extensive scenario based field testing:

– High angle rock rescue

– Ice and snow rescue

– Wilderness search

• Teams must reaccredit every 5 years

– Tested and judged by members of regional and out of state teams

MRA

• Yearly national meeting

– Field activities and presentations related to developments in SAR technology and techniques, and mountain emergency medicine

• International Technical Rescue Symposium (ITRS)

– Advances in technical mountain rescue and gear, and systems testing

MRA Medical Committee

• Article in quarterly MRA publication pertinent to mountain medicine

• Reviewed by MEDCOM members

• Periodic practice guidelines

MRA – SAR Mission

• Search: for lost outdoor participants

• Rescue: when found

• Provide medical care: usually in wilderness medical setting, frequently in austere conditions

• Never a charge for rescue

– Encourage calling early

– Charges may occur from other organizations for transport or hospital care

MRA - Availability

• Any time day or night

• Every day and night

• All seasons

International Commission for Alpine Rescue – ICAR www.alpine-rescue.org

• Founded in 1948, 35 countries

• Four commissions:

– Terrestrial rescue

– Air rescue

– Snow rescue

– Mountain emergency medicine

ICAR Medical Committee

• US delegates from MRA

• Elaboration of recommendations and guidelines dealing with scientific and practical aspects of mountain rescue and emergency treatment of casualties in mountainous terrain

• All recommendations and guidelines are published in international peer reviewed journals

International Union of Alpine ClubsInternational Mountaineering and Climbing

Federation

• International governing body of climbing and mountaineering

• Safety standards for climbing equipment and guiding certification

Diploma in Mountain Medicine

• ICAR MEDCOM, UIAA MEDCOM, ISMM (international Society for Mountain Medicine)

• Mountain medicine topics

• Mountain rescue proficiency on land, air, snow

• Standardizes training for physicians involved in mountain medicine and rescue in mountain areas

Alpine Rescue TeamEvergreen, CO www.alpinerescue.org

• Organized 1959

• Conduct search, (remote areas), rescue, recovery, all terrain (high altitude, high angle technical rock rescue, avalanche response

• Any day, night or day, any weather conditions

Alpine Rescue TeamEvergreen, CO www.alpinerescue.org

• Teach individuals and groups safe mountaineering practices and safety in the mountains

• Cooperate with other SAR groups via formal association and agreements to local regional, national and international levels

• CSRB (Colorado search and rescue boards)

• Loveland Ski Patrol

Alpine Rescue TeamEvergreen, CO www.alpinerescue.org

• Coverage area: Clear Creek, Jefferson, Gilpin Counties

• Dispatched by Sheriff’s Office

• Covers four 14’ers

• 65 field active and technical specialist members

• Evergreen facilities

• No charge for rescue

• 125 missions per year: search, rescue, recovery

Alpine Rescue TeamEvergreen, CO www.alpinerescue.org

• Funded by donations

• CORSAR card (Colorado Outdoor Recreation SAR card)

– Not insurance – does not pay for medical transportation or hospital care

– Does allow some reimbursement by state through Sheriff’s Office to replace destroyed equipment

Alpine Rescue TeamEvergreen, CO www.alpinerescue.org

• Medical Care

– OEC (Outdoor Emergency Care) or higher

– Medical Committee

– Medical Director: Interface with St. Anthony Hospital, Centura Health Care, Flight for Life, HAATS

Wilderness Medicine

• Providing vital emergency care in remote settings

• Usually involved with potentially hazardous activities in the back country

• Not just ER medicine, and certainly not hospital medicine

• SAR medicine, diving and hyperbaric, tropical and travel, high altitude and mountaineering, expedition, environmental, submersion/drowning, disaster/humanitarian

Wilderness Medical Society

• Many programs to train, not standardized

• Advance healthcare, research and education related to wilderness medicine

• Advice, guidance to medical personnel working in wilderness environment

Wilderness Medical Society

• Meetings, publications, Wilderness and Environmental Medicine Journal, Wilderness Medicine Newsletter, Practical Guidelines for Wilderness Emergency Medicine

• Certifications: AWLS, FAWM, DIMM

• Sponsoring residency programs

Wilderness Medicine

• What makes wilderness medicine different?

– Challenges………Equipment

– Differences……..Environment

– Improvising……..Without Equipment