ICAR MEDCOM Mountain Current

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Current status ofmountainemergency medicineICAR MEDCOMH. Brugger, Fidel Elsensohn, Dave Syme, Günther Sumann, Markus FalkICAR Congress Zakopane 2004

14 ICAR countriesAustria (A)Canada (CA)Croatia (CR)Czech Republic (CZ)England and Wales (E W)Germany (D)Italy (I)Poland (PL)Scotland (SCO)Slovakia (SK)Slovenia (SLO)Spain (E)Switzerland (CH)USAInquiry 2004

Ground mountain rescueRescuersTotal rescuersGovernmentalNon-governmentalPaidNot 0.5%37535100%9622.6%3657397.4%485012.9%3268587.1%

Physicians in mountain rescueTotal physiciansAnaesthesistsOther specialistsGeneral 45734.7%63448.2%

Helicopter rescueStaffContinental E W, NA,SCOEuropeTotal helicopters155592100%100%Staffed with Physician108*183*69.7%30.9%Staffed with Paramedic14**357**9.0%60.3%Without medical personnel335221.3%8.8%*,** P 0.001Total747100%29138.9%37149.7%8511.4%

Physicians in mountain rescueSpecific training and abilitiesYesNoTrained in mountainemergencymedicineA, CH, CR,D, E, PLCA, CZ, E W, I,SK, SCO, SLO,USATrained in mountainrescue techniquesA, CA, CH, CR,CZ, D, E, E W,PL, SK, SLO, USAI, SCOA, CA, CH,CR, CZ, D, E,I, PL, SLO, USAE W, SCO,SKSelected bymountaineeringabilities

Paramedics in mountain rescueTraining and abilitiesYesA, CA, D, E, E W, PL,SCO, SK, SLO, USANoITrained inmountain rescuetechniquesA, CA, CH, D, E W, I,SK, SLO, CH, USASCOSelected bymountaineeringabilitiesA, CA, D, I, PL, SK,SLO, USACH, E W,SCOTrained infirst aid

Mountain rescueOn-site treatmentCA,USACR,E WE, SLOAccording toILCOR or 25% 25-50% 50-75%ICAR guidelinesA, CZ,D, PL,SCO,SK,CH, I 75%100%The percentages vary significantly among the questionedcountries (P 0.001) and are positively correlated to thepercentage of helicopters with physicians on board (r 0.76,P 0.001 Spearmen rank correlation).

Helicopter rescueMountain rescue involvedA, CA, D, IAs part of theair rescue teamCH, CR, CZ, E, E W,PL, SK, SCO, SLO, USAEn demand“picked up”Keeping experienced rescuers permanently on thehelicopter base is considered as the ideal conditionfor a professional air rescue in mountainous terrain.

1. ICAR MEDCOM recommendationPhysicians and paramedicsshould receive a standardisededucation and training inspecific, mountain rescuerelated problems of emergencymedicine according toprotocols defined by ICAR-,UIAA- MEDCOM* and ISMM* Peters P. Recent Developments in Mountain Medicine Education. In: Elsensohn F (ed) ConsensusGuidelines on Mountain Emergency Medicine and Risk Reduction. Lecco: Stefanoni 2003:89-94.

2. ICAR MEDCOM recommendationAll medical personnel operatingin mountain rescue should bephysically trained and selectedfor their mountaineeringabilities according to ICARMEDCOM recommendations.** Rammlmair G, Zafren K, Elsensohn F. Qualifications for Emergency Doctors in Mountain RescueOperations. In: Elsensohn F (ed) Consensus Guidelines on Mountain Emergency Medicine and RiskReduction. Lecco: Stefanoni 2003:31-32.

3. ICAR MEDCOM recommendationIdeally physicians, paramedics andmountain rescuers in a helicoptermountain rescue team should beintegrated as part of a regular flyingcrew, wherever logistically andeconomically possible. This wouldenable the highest possible reliability fora safe evacuation of the casualty.** Tomazin I. Activation and Rational Use of Rescue Helicopters. In: Elsensohn F (ed) ConsensusGuidelines on Mountain Emergency Medicine and Risk Reduction. Lecco: Stefanoni 2003:85.

4. ICAR MEDCOM recommendationThe risk of using a helicopter forthe evacuation of a casualty inmountainous areas should bebalanced with the patient’s benefit,according to the standards,approved by the InternationalCommission for MountainEmergency Medicine*.* Tomazin I. Activation and Rational Use of Rescue Helicopters. In: Elsensohn F (ed) ConsensusGuidelines on Mountain Emergency Medicine and Risk Reduction. Lecco: Stefanoni 2003:85.

4. ICAR MEDCOM recommendationFurther research should be made toclarify the relationswhip betweenthe quality and efficiency of on-sitetreatment and whether physiciansor ALS-trained paramedics areoperating at the scene.

32.700 rescuers arevolunteering formountain rescueoperations withoutbeing paid for theiractivities

The largest and highestmountains in the world as partsof the Andes, the Himalayas andmany other areas are minimallycovered by skilled rescueservices.