Dr. Paul Auerbach is the world's leading outdoor health expert. His blog offers tips on outdoor safety and advice on how to handle wilderness emergencies.See all posts »
Ski Patrols and Emergency Medical Services
In the most recent issue of Wilderness & Environmental Medicine appears an article by Drs. Ben Constance and David Johe, and me, entitled “Prehospital Medical Care and the National Ski Patrol: How Does Outdoor Emergency Care Compare to Traditional EMS Training?” (WEM 2012;23:177). The purpose of the study underlying the article was to identify the specific differences between the educational curricula, skill sets, and funds of knowledge required for certification as an Outdoor Emergency Care Technician (OEC-T), Emergency Medical Technician (EMT), and Emergency Medical Responder. We did this because we have been listening to arguments for years about whether or not the Outdoor Emergency Care-trained individual is equivalent to an EMT for the purposes of practice, and perhaps even certification. People on both sides of the argument sometimes get heated up during the discussion, but we have never seen an objective listing of the curriculum items such that we might go at this “apples to apples.” We concluded that the OEC-T curriculum includes a skill set and fund of knowledge that exceeds those of the EMR program, but does not include all the knowledge needed to become certified as an EMT.
The OEC-T program prepares a person to care for patients in the wilderness, with special emphasis on snowsports pathology. The EMT program places greater emphasis on medical diseases and emergency medication administration. As Steve Donelan pointed out in his introduction to the Wilderness Instructor section of the journal, which is where our article appeared, one should never lose sight of the context in which medical training will be deployed. It is one thing to apply a splint in the city and need it to be effective for a controlled 10-minute transport to the hospital in the back of an ambulance, and quite another to apply a splint on a steep ski slope, package the patient in a litter, and endure a bumpy ride over winter terrain during a blizzard.
An accompanying editorial entitled “The Relationship Between Ski Patrols and Emergency Medical Services Systems” was provided by Dr. Seth Hawkins. He eloquently sets into context the discussion that we hoped would ensue by our writing this article. Namely, it is time to consider all the permutations of training, responsibilities, realities of personnel availability, regulations, local customs and financial considerations that go into creating a ski patrol service designed to improve the health and safety of persons engaged in winter sports. There are arguments pro and con for every conceivable configuration, and I have no preconceived notion of how it should be, other than it should be the best that can be created given the needs of the skiers and the locally available medical talent.
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