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Medicine for the Outdoors
Medicine for the Outdoors

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.

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A Week on the Hill


I just returned from spending a few days on the slopes as a member of the doctor patrol at a downhill ski resort in the Sierra Nevada mountain range in the state of California. The patrol is a volunteer activity in which the doctor(s) assists the ski patrollers with medical issues when summoned to a scene or the first aid room. Because there hasn't been a tremendous amount of snowfall quite yet, the resort was not as crowded as usual during the holidays, which was good from an injury perspective.

However, people still get hurt, because there were falls and collisions. In discussing each days' events with the highly experienced and attentive ski patrol members, they had some interesting observations. With regard to injuries on the slopes, technology is both friend and foe. While new equipment, such as improved boots and bindings, helps prevent orthopedic injuries, the ever-improving skis and snowboards allow skiers of lesser abilities (and frequently less experience) to attempt steeper slopes and more difficult terrain. This puts them into situations where experience and judgment might combine to help avoid injuries. People who take only a few ski or snowboarding lessons leave their instructors to attempt double black diamond inclines on their own, and they are not prepared to handle them.

Peer pressure is definitely a factor, much more so for the younger crowd. In the midst of a minor blizzard and temporary "white-out," I observed three young men strip to the waist and ski, sans jackets and helmets, onto a busy slope so that they could get a picture for their friends. They weren't breaking any rules - just testing Darwin's Law.

I am completely convinced that the major contributor to injuries is speed. The faster that people ski or snowboard, the more likely that a fall or collision will result in a significant injury. Machine-groomed steep slopes are common, and high-speed lifts deliver people to the top efficiently. This puts greater numbers of individuals on these steep slopes at any given time, which contributes to falls and collisions. As one learns to drive defensively, one should ski defensively. This may take away some of the thrill, but it is the sensible thing to do.

The number one way to prevent injuries is to ski under control, and this is, unfortunately, less often the rule when people ski or board too fast. It seems as if many skiers and snowboarders have lost respect for the mountain and forces of nature, or never properly appreciate them in the first place. High winds, particularly on ridges, may make the terrain icy, and this leads to loss of control and accidents. People ski in conditions for which they are not prepared, such as white-outs and deep powder in boundary areas, which leads to lost persons and tales of survival.

In terms of equipment, the best insurance policy is a helmet. There is no question that helmets prevent or diminish head injuries. In my activities this season as a member of the doctor patrol, I have already cared for too many individuals who suffered concussions that would have been prevented had they been wearing helmets. There’s no explanation, including that of personal freedom, that I can support, to argue against helmet use. They are advised for skiers at any age and level of experience.

So, enjoy the slopes, but ski or snowboard safely and do your best to participate within your personal limits. When you take on more challenging terrain, try to do so under optimal conditions in the presence of persons who can assist you should you get in over your head, become injured, or otherwise require a rescue.

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About the Author

Dr. Paul S. Auerbach is the world’s leading authority on wilderness medicine.

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