To provide guidance to clinicians and avalanche professionals about best practices, the Wilderness Medical Society convened an expert panel to develop evidence-based guidelines for the prevention, rescue, and medical management of avalanche and nonavalanche snow burial victims. Recommendations are graded on the basis of quality of supporting evidence according to the classification scheme of the American College of Chest Physicians.

The Wilderness Medical Society convened an expert panel to develop evidence-based guidelines for the management of pain in austere environments. Recommendations are graded on the basis of the quality of supporting evidence as defined by criteria put forth by the American College of Chest Physicians. This is an updated version of the original WMS Practice Guidelines for the Treatment of Acute Pain in Remote Environments published in Wilderness & Environmental Medicine 2014;25(1):41-49.

P Pr ra ac ct ti ic ca al l F Fu un nc ct ti io on na al l A As ss se es ss sm me en nt t o of f E El ld de er rl ly y P Pe er rs so on ns s: : A A P Pr ri im ma ar ry y--C Ca ar re e A Ap pp pr ro oa ac ch hThe following is abstracted from:Fleming KC, Evans JM, Weber DC and Chutka DS. Practical Functional Assessment of Elderly Persons: A Primary-Care Approach. Mayo Clinic Proceedings 1995: 70:890-910."Studies have shown that use of formalized comprehensive geriatric assessments can result in improved survival, reduced hospital and nursing home stays, decreased medical costs, and improved functional status. In addition, geriatric assessment can help in determining patient placement, assistance needed for daily activities, selection of medications, and prognosis. This paradigm shift of care -from disease-oriented to function-oriented assistance -entails knowledge of social, cognitive, and mobility factors that are seldom considered within the scope of traditional medical practice. Older persons can benefit from this change in focus. Small improvements in functional, psychologic, or cognitive abilities may provide substantial benefits in the patient's quality of life."

Reports of overdue persons are common for search and rescue personnel. Search incidents for missing persons are conducted following established industry standard practices, which are continuously refined through experience and the analysis of previous search operations. Throughout this process, elements of uncertainty exist, and the knowledge and experience of the searchers and search managers may influence the outcome significantly. A sound knowledge of current search tactics will help search and rescue medical providers function more effectively during search operations. Initial actions during a search incident include 3 primary tasks that must be accomplished on any search: investigation, containment, and then hasty search efforts. Concurrent with these initial actions are the establishment of the search area and a formal US National Incident Management System incident command system. That is essential for an efficient operation and will lay the groundwork for expanding the operation past the initial operational period. The goal of applying these standard search management practices is to allow searchers to maximize their efforts, reduce some of the inherent uncertainty, and most importantly, place searchers in a position to detect the missing person.