Search and Rescue in the Intermountain West

Abstract

The search and rescue (SAR) teams of the intermountain west states (Arizona, Colorado, Idaho, Montana, Nevada, New Mexico, Utah, Wyoming) are some of the most active in the United States. Minimal data exist regarding the membership, medical training, and SAR missions of these teams. The purpose of this study is to describe these SAR organizations including medical care provided, call volume, and trainings. Additionally, the involvement of physician medical direction and authorized expanded scopes of practice will be analyzed. Electronic surveys were sent to local SAR officials in each county (281) within the intermountain west states. Results were descriptively analyzed. Fifteen percent of jurisdictions responded to the survey. (All data presented represent only the first week of response data; data collection is ongoing and the authors expected completion by January 2013.) The median annual call volume was 37 (5–152) missions. Teams were composed of a median of 35 (5–132) volunteers and 0 (0–26) paid members; 83.3% of teams provide medical training to their membership. Multiple levels of medical training are represented on teams, including First Aid/CPR, EMR, EMT, AEMT, Paramedic, RN, APRN, PA, and MD/DO. Of these medical professionals, 23.2% have formal wilderness training, ranging from 0% to 100% on a team level. Of the medical care on SAR missions, 61.3% is performed by local EMS rather than by the SAR team. Of the SAR teams, 48.4% have formal medical direction, and 77.8% of that direction comes from physicians; 85.7% of those physicians are emergency medicine trained. Owing to the remote nature of SAR medical care, 23.3% of medical directors have protocols allowing for an expanded scope of practice. Intermountain west SAR teams vary in their composition, training, and level of medical direction. Medical directors can participate in a range of activities, including creation of medical protocols, training activities, missions, online medical consultation, and making provisions for prescription medications. There is a national push to increase medical direction of prehospital services, and this study confirms that vast opportunities exist for physician integration with SAR teams.