Utah Ski Patrol: Assessing Training Types and Resources

Sagalyn, Emily B.; McDevitt, Marion; Ernst, Ryan

doi:10.1016/j.wem.2014.06.004

Cited by 3 publications

(6 citation statements)

References 10 publications

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“…5 Barriers to timely and effective prehospital analgesia include lack of certified personnel and restrictive protocols. [6][7][8][9][10] For rescuers like ski patrollers, these barriers are further compounded by the unique difficulties of a winter environment. The transport of an injured patient by ski patrol often involves a long and uncomfortable sled ride, with transport times ranging from 10 min to more than an hour for more prolonged evacuations.…”

Section: Introductionmentioning

confidence: 99%

“…26 For EMS-affiliated ski patrols, administration of opioid analgesics is further limited to personnel with paramedic-level certifications or higher, comprising an even smaller subset of patrollers. 7 We present data on the use of IN fentanyl in ski patrol or wilderness settings. Intranasal fentanyl eliminates many barriers to achieving on-the-hill analgesia presented by environmental and austere factors.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Intranasal Fentanyl for On-the-Hill Analgesia by Ski Patrol

Lynch

Callas

Peterson

et al. 2022

Wilderness & Environmental Medicine

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Introduction-Intranasal fentanyl offers a means for safe and effective pain management in austere environments. Prehospital analgesia traditionally involves intravenous or intramuscular medication. However, for wilderness rescuers, these methods are often impractical.Methods-We conducted a retrospective review of health records to evaluate the safety and efficacy of intranasal fentanyl administered by EMT-Basic certified ski patrollers. Our primary aim was to measure the reduction in initial pain scores to subsequent measurements at 5, 10, and 15 min using the pain numeric rating scale (0-10). Clinically significant reduction in severe pain has been established as ≥1.8 points. We used paired t-tests and multilevel modeling to measure statistical significance and potential interactions and reviewed patient charts for adverse events, including respiratory depression or the use of naloxone.Results-We compiled the results from the winter seasons for 2007 through 2012 and 2016 through 2020. A total of 247 patients were included. The initial pain score was 8.6±1.5 (mean±SD). The decrease in pain scores from 0 to 5, 10, and 15 min, respectively, was -1.8, -2.4, and -2.9 (P<0.0001), which demonstrated a clinically and statistically significant decrease in pain scores. There were no adverse events.Conclusions-Traditional standard of care analgesics are invasive, elongate scene times, and increase the risk of environmental exposure and provider needlestick. Intranasal fentanyl offers a safe, noninvasive, and rapid analgesia that is well-suited for austere winter environments, such as those encountered at ski resorts. This study demonstrates the safety and efficacy of the administration of intranasal fentanyl by EMT-Basic certified providers.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Intranasal Fentanyl for On-the-Hill Analgesia by Ski Patrol

Lynch

Callas

Peterson

et al. 2022

Wilderness & Environmental Medicine

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“…Furthermore, because ski patrols provide prehospital medical care that exceeds the scope of Good Samaritan or Basic First Aid practice, 7 many experts argue that ski patrols, by definition, practice emergency medical services, and should, therefore, become formally affiliated with emergency medical services agencies. 8,9 While there has been 1 study that investigated the basic medical care provided by ski patrols in 9 ski areas in Utah, 10 there have been no studies that investigated ski patrols, their medical direction, and their protocols throughout the entire US region. The purpose of this project was to characterize the medical training, patient care, scope of practice, medical direction, and oversight of US ski patrols through a survey of both ski patrol directors and, if applicable, their medical directors.…”

Section: Introductionmentioning

confidence: 99%

“…While there has been 1 study that investigated the basic medical care provided by ski patrols in 9 ski areas in Utah, 10 there have been no studies that investigated ski patrols, their medical direction, and their protocols throughout the entire US region. The purpose of this project was to characterize the medical training, patient care, scope of practice, medical direction, and oversight of US ski patrols through a survey of both ski patrol directors and, if applicable, their medical directors.…”

Section: Introductionmentioning

confidence: 99%

A Survey of Ski Patrols in the United States Comparing Medical Direction, Patroller Training, and Patient Care

Fell,

Linney,

DeLoughery

et al. 2023

Wilderness & Environmental Medicine

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Introduction-Ski patrols are tasked with substantial challenges: distance from definitive care, complex extrications, and winter environments. Rules for US ski patrols stipulate that ≥1 persons be trained in basic first aid, but no further regulations regarding the specifics of provided medical care exist. This project investigated patroller training, patient care, and medical direction of US ski patrols through a survey of ski patrol directors and medical directors.Methods-Participants were contacted via email, phone, and personal contacts. After consultation with known ski patrol directors and medical directors for question guidance, 2 separate institutional review board-approved surveys were designed: 1 for ski patrol directors and 1 for ski patrol medical directors, containing 28 and 15 qualitative questions, respectively. The surveys were distributed with a link to the encrypted Qualtrics survey platform. After 2 reminders and 4 mo, results were downloaded from Qualtrics into an Excel spreadsheet.Results-Twenty-two responses from patrol directors and 15 from medical directors were received. The response rate is unknown. Outdoor emergency care certification was the minimum medical training required by 77% of the study participants. Twenty-seven percent of surveyed patrols belonged to an emergency medical service agency. Fifty percent of 11 surveyed ski patrols had a medical director, 6 of whom were board certified in emergency medicine. All surveyed medical directors stated that they assisted with patroller education, and 93% assisted with protocol development.Conclusions-The surveys demonstrated variability in patroller training, protocols, and medical directorship. The authors questioned whether ski patrols would benefit from increased standardization of care and training, quality improvement programs, and medical directorship.

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Pain Management with Inhalation of Methoxyflurane Administrated by Non-Medical Ski Patrol: A Quality Assessment Study

Rydlöv,

Fjose,

Heyerdahl

2023

Pain Ther

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Introduction Pain management can be challenging, especially in remote locations where first responders are not certified health care personnel. In these settings, traditional intravenous administration of analgesics is not feasible. In this study, we explore the feasibility of using methoxyflurane as a first-line analgesic in ski-related traumas, administered by the ski patrol, acting as the municipality physician’s aiding personnel. Methods This is a quality assessment of a project aimed at improving pain management in trauma patients at the largest ski resort in Norway. Members of the ski patrol were trained and delegated administration of methoxyflurane on behalf of the municipality physician. Patients > 18 years with ski-related trauma and pain Numeric Rating Scale (NRS) of 6 or more were included. The patients received inhalational methoxyflurane on site, with continued administration during transport. Data were collected by the ski patrol and entered into a quality register. Results In total, 53 patients (18 to 76 years, 32 (60%) males) accepted to be registered. The injuries were fractures in 35 (66%), joint luxation in seven (13%), combination of fracture and luxation in seven (13%), and blunt soft tissue damage in four (8%) cases. Median NRS before administration of methoxyflurane was 8 decreasing to median NRS 5 after 5–10 min. The median NRS reduction of 3 (25–75% percentiles 2–5) was significant, p < 0.001. Patients rated the perceived effect as good in 40 (80%) moderate in nine (18%) and no effect in 1 (2%). Side effects were mild: Six patients (11%) experienced dizziness, one patient (2%) was considered drowsy. Conclusions Methoxyflurane is feasible as a first-line analgesic administered by a non-medical ski patrol in a responsibly organized system. Early pain management with inhalation of methoxyflurane provides good perceived effect with mild adverse events and can be of great value in settings where few alternatives for pain management are available.

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Utah Ski Patrol: Assessing Training Types and Resources

Cited by 3 publications

References 10 publications

Intranasal Fentanyl for On-the-Hill Analgesia by Ski Patrol

Intranasal Fentanyl for On-the-Hill Analgesia by Ski Patrol

A Survey of Ski Patrols in the United States Comparing Medical Direction, Patroller Training, and Patient Care

Pain Management with Inhalation of Methoxyflurane Administrated by Non-Medical Ski Patrol: A Quality Assessment Study

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