Mountain Rescue Teams Research Articles

The Outcome of Walking Cold Patients with Potential Mild Hypothermia to Safety-A Mountain Rescue Case Series.

Some experts recommend that ambulant hypothermic patients should be rewarmed, fed, and not permitted to exercise for 30 min because of concerns that afterdrop can cause cardiac instability. We investigated the outcome of ambulant hypothermic patients in a case series from mountain rescue teams in Great Britain. A questionnaire was used to collect information on a series of adult patients with a clinical diagnosis of mild hypothermia. All patients were alert on the AVPU scale and evacuated by walking from the mountain. The outcome measures were survival or a change in management because of medical deterioration during evacuation. A series of 108 eligible cases were reported over a 5-year period. When rescuers arrived on the scene, 98 (91%) patients were stationary, and 10 (9%) were still mobile. Thirty-eight (39%) of the stationary cases were walked immediately off the mountain without any on-scene delay. In the remaining 60 (61%) stationary cases, the decision was taken to delay evacuation to provide food, drinks, and additional clothing. In 3 cases, the use of heat packs indicated an intention to actively rewarm. In cases where the on-scene time was reported, 27 (79%) were known to be mobile again within 20 min. All patients survived, and no adverse medical events occurred in all 108 cases. In this study, no adverse events occurred because of immediate mobilization, suggesting that in these cases, there appears to be minimal risk of early activity.

A lightweight ontology for landmarks to assist rescue in mountainous areas

Abstract. When people are injured or lost in mountains during outdoor activities and when web-based locations are not available, they locate themselves by describing their environment, routes and activities. The description of their location is done using landmarks and spatial locations (e.g., “I am located in front of Punay Lake”, “I am near a protected area”). Landmarks used can be named (e.g., “Punay Lake”) or unnamed if the landmark has no name or if the victim does not know it (e.g., "area lake"). Landmarks are represented in geographic databases by name (if possible), type and geometry. To reduce the heterogeneity of landmark types present in oral language and geographic databases representing landmarks, and thus improve locating victims, our goal is to define a controlled vocabulary for landmarks. In this research, we present a lightweight ontology (i.e. ontology having generally less complexity and does not express formal constraints) of landmarks, named Landmark Ontology (OOR), describing landmark types. It is an application ontology, i.e. it is designed to support mountain rescue operations. The ontology construction is adapted from the SAMOD methodology for engineering ontology development and involves researchers and experts from mountain rescue teams. The construction of OOR is composed of four main phases: knowledge acquisition, conceptual formalisation, implementation, and testing. The implementation phase is carried out by an iterative and collaborative approach and using four formalised sources of knowledge (a landmark and a landform ontologies, and two other domain vocabularies), an un-formalised taxonomy of outdoor activities, and five authoritative and volunteered geographic information sources representing geographic data. The landmarks ontology contains 543 classes associated with 1739 labels: 1086 prefLabel (preferential label) in French and English, 321 altLabel (alternative label) in French, and 332 altLabel in English. The depth of the ontology varies from four for land cover, hydrological and land subdivision landmark types), to six for landform types, and eight for building types. Although the use of ontology is broader, in this paper we illustrate and test its use through three applications in the context of mountain rescue operations: semantic mapping, data instantiation and data matching.

Personal Protective Equipment Protocols Lead to a Delayed Initiation of Patient Assessment in Mountain Rescue Operations.

van Veelen, Michiel J., Giulia Roveri, Ivo B. Regli, Tomas Dal Cappello, Anna Vögele, Michela Masè, Marika Falla, and Giacomo Strapazzon. Personal protective equipment protocols lead to a delayed initiation of patient assessment in mountain rescue operations. High Alt Med Biol. 24:127-131, 2023. Introduction: Mountain rescue operations can be challenging in austere environmental conditions and remote settings. Airborne infection prevention measures include donning of personal protective equipment (PPE), potentially delaying the approach to a patient. We aimed to investigate the time delay caused by these prevention measures. Methods: This randomized crossover trial consisted of 24 rescue simulation trials intended to be as realistic as possible, performed by mountain rescue teams in difficult terrain. We analyzed the time needed to perform an airborne infection prevention protocol during the approach to a patient. Time delays in scenarios involving patients already wearing versus not wearing face masks and gloves were compared using a linear mixed model Results: The airborne infection prevention measures (i.e., screening questionnaire, hand antisepsis, and donning of PPE) resulted in a time delay of 98 ± 48 (26-214) seconds on initiation of patient assessment. There was a trend to a shorter time to perform infection prevention measures if the simulated patient was already wearing PPE consisting of face mask and gloves (p = 0.052). Conclusion: Airborne infection prevention measures may delay initiation of patient assessment in mountain rescue operations and could impair clinical outcomes in time-sensitive conditions. Trial registration number 0105095-BZ Ethics Committee review board of Bolzano.

Модели и алгоритмы создания комплексных аварийно-спасательных формирований на объектах горнорудной промышленности

Introduction. The article discusses scientific approaches and regulatory requirements for the creation and functioning of emergency services at mining facilities. Special emergency rescue services at mining facilities respond to a variety of accidents and incidents by nature, the types and frequency of which depend on the danger of the enterprise, which requires the creation of several specialized emergency rescue services independent of each other. The costs of maintaining emergency rescue units are borne by enterprises, and in the conditions of a significantly large staff of such services, they can become unacceptably high. In this regard, there is an economic justification for combining the personnel of operational duty shifts of several specializations of activities aimed at optimizing the staffing of services and formations. The purpose of the study is to increase the level of safety of mining facilities based on the development of models and algorithms for the creation of complex emergency rescue units capable of responding to all types of possible accidents and incidents. Research methods. The article uses the method of analytical research based on the results of the analysis of work in the field of organizational design of regular structures of emergency services. The results of the study. Approaches to the creation of emergency rescue services at industrial facilities are defined. The models of creation of complex emergency rescue formations and the algorithm of creation of emergency rescue formations at mining facilities are proposed. Conclusion. The current norms for determining the organizational structures of mountain rescue teams do not take into account the types of accidents, the specifics of their development and the response of emergency rescue units to their elimination. The authors have proposed models of complex emergency rescue units at mining facilities, allowing, depending on the chosen option, to respond to all possible accidents and incidents. The proposed models and algorithm allow emergency rescue units at mining facilities to optimize the organizational and staff structure by combining rescuers of various specializations of activity, which in turn can reduce the costs of the enterprise for the maintenance of emergency services. Keywords: accident; emergency rescue formation; mining rescue squad; mining industry; damaging events; incident; hazardous production facility; organizational design; organizational and staff structure.

CAUSES FOR SEARCH AND RESCUE IN ROCK CLIMBING ACCIDENTS IN POLISH TATRA MOUNTAINS – A 5-YEAR SURVEY

Aim: To review Tatra MRT (Mountain Rescue Team) SAR (search and rescue) events reported by rescuers in the study period of 2015-2019 (5-year survey) in terms of the profile of the injured, types of injuries, causes identified by MRT rescuers in reference to the NACA ICAR (National Advisory Committee for Aeronautics – International Committee for Alpine Rescue) score. Material and methods: A study was conducted on Tatra MRT reports, regarding RC (rock climbing), from 2015 through 2019. Reports included information on the trauma, possible causes, accompanying weather conditions and actions that were taken. The study group consisted of 174 report with a median age of 32.5 years (IQ I-III – 27–41) comprising 137 men and 37 women. Results: Our study revealed that there was no relation between RC SAR reported by Tatra MRT rescuers and age or sex. Apart from one – the fall from heights, causes were also not related with age or sex. According to our study older people were more likely to sustain a trauma as a result of a fall from heights (34 vs 31, p=0.009). We found that 42% of the victims did not sustain any actual trauma (NACA ICAR=0). According to the rescuers these cases were significantly more likely to be associated with the lack of skills or inadequate equipment (p<0.001). Conclusions: RC incidents constitute a small percentage of SAR operations by Tatra MRT. Almost half of RC SAR incidents is not associated with an actual trauma.

COVID-19 Pandemic in Mountainous Areas: Impact, Mitigation Strategies, and New Technologies in Search and Rescue Operations.

van Veelen, Michiel J., Anna Voegele, Simon Rauch, Marc Kaufmann, Hermann Brugger, and Giacomo Strapazzon. COVID-19 pandemic in mountainous areas: impact, mitigation strategies, and new technologies in search and rescue operations. High Alt Med Biol. 22:335–341, 2021.—Mitigating the spread of COVID-19, an airborne infection, can lead to delays in the prehospital response and impair the performance of search and rescue (SAR) services in mountainous and remote areas. We provide an overview of the developing epidemiological situation related to the COVID-19 pandemic in mountainous areas and review current protocols to determine their suitability for mountain rescue teams. We also discuss using novel technologies to reduce the adverse effects caused by COVID-19 mitigation strategies such as delays caused by donning personal protective equipment (PPE) and reduced rescuer performance due to impaired movement and ventilation. COVID-19 has spread even in mountainous and remote locations. Dedicated protocols for the use of PPE appropriate for SAR rescuers exerting physical effort in remote areas and using technologies such as drones, telemedicine, and localization and contact tracing applications could contribute to an effective and timely emergency response in mountainous and remote settings.

The effects of NO on the urea cycle pathway in short-term intermittent hypobaric hypoxia in rats

Short-term hypoxic states can influence the health and life activities of lowlanders who travel shortly to high altitudes, in transitory situations, such as surgical ischemia-reperfusion (to one or several organs), and in some sporting activities, such as parachuting and extreme skiing, mountain rescue teams, regular commercial flight crews, in which the subject may not even notice the hypoxia. NO is an integral part of the human physiological response to hypoxia. Until recently, the urea cycle (UC) was only considered as an important mechanism for neutralizing ammonia. We are the first to reveal an interrelation in hypoxic states between the activities of NO-synthase and UC enzymes in male rats' liver, kidney and brain. In the presented work, we have shown that during short-term intermittent hypobaric hypoxia (IHH) all enzymes of UC play an important role in the maintenance of NO quantity. The results allow thinking that kidney and brain argininosuccinate synthase (ASS) and argininosuccinate lyase (ASL) and liver ASS and ASL can be different isoenzymes. It is worth mentioning that the results have revealed new sides of l-arginine metabolism in a hypoxic state in male rats.

Oględziny i dokumentacja zdarzeń o charakterze upadku z wysokości w terenie eksponowanym i jaskiniach z udziałem ratowników Grupy Jurajskiej Górskiego Ochotniczego Pogotowia Ratunkowego

The article is devoted to issues related to the use of forces and resources of mountain rescue teams during visual inspection of incident areas in exposed areas and caves. The article presents general assumptions about the organization and coordination of this type of inspection from the moment of receiving information about the event and the start of rescue operations by GJ GOPR, until the completion of collecting and securing all infor-mation and evidence as part of the inspection of the incident scene. The article contains issues related to the exchange of information between the involved entities, preparation of documentation meeting formal and legal requirements by trained GJ GOPR rescuers, securing items that may constitute evidence in subsequent proceedings, and the handling of human corpses and remains.

Age and Sex Are Strongly Correlated to the Rate and Type of Mountain Injuries Requiring Search and Rescue Missions

Because of the growing popularity of mountain tourism, the number of injuries related to mountain activities has increased rapidly. The regional volunteer search and rescue team (Tatra mountain rescue team [MRT], Poland) anticipates future increases in injuries and accidents. An analysis was performed on Tatra MRT incident reports for the years 2012 through 2013. These reports include information on the mechanism of injury, weather conditions, and demographic data of the injured tourists. The data were provided by the operation supervisor of each search and rescue mission. The study group consisted of 844 reports (median age 37 y, range 18-90 y). The analysis was designed to determine whether features such as age and sex of the injured tourist were correlated to the injury mechanisms (as identified by the rescuers) or their National Advisory Committee for Aeronautics-International Committee for Alpine Rescue (NACA ICAR) score. Our study of the Tatra MRT data revealed that age and sex are risk factors for the rate and severity of injuries in the mountain environment. Injured men were more likely to require resource-intensive search and rescue missions and usually had a worse NACA ICAR score (P=0.041). The age analysis showed that older people are more likely to sustain a serious injury (3-7 NACA ICAR score). However, the most common rescue scenario involved younger males (20-40 y) at a higher altitude (>1500 m, P<0.001). Sex and age are associated with the mechanisms and severity of injuries in the mountain environment. They should be considered in the development of appropriate prevention and response programs. Further studies are needed to confirm the results.

Deep Learning Approach in Aerial Imagery for Supporting Land Search and Rescue Missions

In this paper, we propose a novel approach to person detection in UAV aerial images for search and rescue tasks in Mediterranean and Sub-Mediterranean landscapes. Person detection in very high spatial resolution images involves target objects that are relatively small and often camouflaged within the environment; thus, such detection is a challenging and demanding task. The proposed method starts by reducing the search space through a visual attention algorithm that detects the salient or most prominent segments in the image. To reduce the number of non-relevant salient regions, we selected those regions most likely to contain a person using pre-trained and fine-tuned convolutional neural networks (CNNs) for detection. We established a special database called HERIDAL to train and test our model. This database was compiled for training purposes, and it contains over 68,750 image patches of wilderness acquired from an aerial perspective as well as approximately 500 labelled full-size real-world images intended for testing purposes. The proposed method achieved a detection rate of 88.9% and a precision of 34.8%, which demonstrates better effectiveness than the system currently used by Croatian Mountain search and rescue (SAR) teams (IPSAR), which is based on mean-shift segmentation. We also used the HERIDAL database to train and test a state-of-the-art region proposal network, Faster R-CNN (Ren et al. in Faster R-CNN: towards real-time object detection with region proposal networks, 2015. CoRR arXiv:1506.01497), which achieved comparable but slightly worse results than those of our proposed method.

Mountain Rescue Casualty Care and the Undergraduate Medical Elective

Many UK medical curricula lack dedicated prehospital education other than first aid courses and basic life support training. In contrast, nonmedical mountain rescue team members receive advanced prehospital training addressing scene management and various clinical interventions. This article reports a condensed mountain rescue casualty care course designed for medical students by a mountain rescue team. The course was offered as part of a student-selected module during phase 3A at the University of Sheffield Medical School. Within the module, students also learned the relevant biomedical sciences and clinical skills to construct their knowledge of mountain rescue casualty care.

Managing accidental hypothermia: a UK-wide survey of prehospital and search and rescue providers

AimThe management of hypothermic casualties is a challenge faced by all prehospital and search and rescue (SAR) teams. It is not known how the practice of these diverse teams compare....

Severe Hypothermia Management in Mountain Rescue: A Survey Study.

Podsiadło, Paweł, Tomasz Darocha, Sylweriusz Kosiński, Kinga Sałapa, Mirosław Ziętkiewicz, Tomasz Sanak, Rachel Turner, and Hermann Brugger. Severe hypothermia management in mountain rescue: A survey study. High Alt Med Biol 18:411–416, 2017.Introduction: Severe hypothermia is a rare but demanding medical emergency. Although mortality is high, if well managed, the neurological outcome of survivors can be excellent. The aim of the study was to assess whether mountain rescue teams (MRTs) are able to meet the guidelines in the management of severe hypothermia, regarding their equipment and procedures.Methods: Between August and December 2016, an online questionnaire, with 24 questions to be completed using Google Forms, was sent to 123 MRTs in 27 countries.Results: Twenty-eight MRTs from 10 countries returned the completed questionnaire. Seventy-five percent of MRTs reportedly provide advanced life support (ALS) on-site and 89% are regularly trained in hypothermia management. Thirty-two percent of MRTs transport hypothermic patients in cardiac arrest to the nearest hospital instead of an Extracorporeal Life Support facility; 39% are equipped with mechanical chest compression devices; 36% measure core body temperature on-site and no MRT is equipped with a device to measure serum potassium concentration on-site in avalanche victims.Conclusions: Most MRTs are regularly trained in the treatment of severe hypothermia and provide ALS. The majority are not equipped to follow standard procedural guidelines for the treatment of severely hypothermic patients, especially with cardiac arrest. However, the low response rate—23% (28/123)—could have induced a bias.

West Nile virus.

R. Bryan Simon is a contract cardiothoracic surgical nurse based in Fayetteville, W.Va., owner/partner of Vertical Medicine Resources in Portland, Ore., and a director of Appalachian Mountain Rescue Team. He's also a member of the Nursing2017 editorial board. The author has disclosed no financial relationships related to this article.

御嶽山噴火による噴石外傷の経験(An experience of trauma cases: patients hit by rocks during the Mt Ontake volcanic eruption in Japan)

要旨2014年9月27日午前11時52分に御嶽山が噴火し，山頂付近にいた多くの登山者が被災した。岐阜県側の山頂山小屋に負傷者を含む26名の登山者が避難したため，翌朝DMATと山岳救助隊が傷病者救出活動を実施した。被災者のうち，重症者1名，中等症者2名をヘリ搬送し当院に収容した。症例1：39歳女性。左鎖骨・肋骨・肩甲骨開放骨折を受傷しており，全身麻酔下にデブリドマンを施行した。症例2：52歳男性。左上腕骨開放骨折を受傷しており，洗浄・固定術を施行した。症例3：46歳男性。左体幹部に広範な打撲による皮下血腫，腫脹と高CK血症を認めた。3例とも高速飛来物に起因する鈍的外傷および穿通損傷であり，損傷形態は二次あるいは四次爆傷と考えられた。比較的まれな火山噴火による噴石外傷を経験したので報告する。

Ten-minute chat.

Pete Matthews works in mixed practice at Galedin Veterinary in the Scottish Borders. He has been a member of the Tweed Valley Mountain Rescue Team for eight years and last year took on the role of team leader for a three-year term.

Mountain hydrometeorology

Mountain hydrometeorology

Femoral Traction Splints in Mountain Rescue Prehospital Care: To Use or Not to Use? That Is the Question

To determine the incidence of femur fractures in mountain rescue in England and Wales. To investigate the attitudes of rescuers toward the use of femoral traction splints. To review the literature for evidence on the use of traction splints in prehospital medicine and test the hypothesis that femoral traction splints reduce morbidity and mortality in patients with a fractured femur. The Mountain Rescue England and Wales database was searched for cases of suspected fractured femur occurring between 2002 and 2012, a questionnaire was sent to all mountain rescue teams in England and Wales, and a literature review was performed. Relevant articles were critically reviewed to identify the evidence base for the use of femoral traction splints. Femur fractures are uncommon in mountain rescue, with an incidence of suspected femur fractures on scene at 9.3 a year. Traction splints are used infrequently; 13% of the suspected femur fractures were treated with traction. However, rescuers have a positive attitude toward traction splints and perceive few disadvantages to their use. No trials demonstrate that traction splints reduce morbidity or mortality, but a number describe complications resulting from their use. Femur fractures are rare within mountain rescue. Traction splints may be no more effective than other methods of splinting in prehospital care. We failed to identify evidence that supports the hypothesis that traction splints reduce morbidity or mortality. We advocate the use of a femoral traction splints but recognize that other splints may also be appropriate in this environment.

Volunteers in British mountain rescue: responding to increasing demand for rescues and a changed relationship with the state

Mountain rescue (MR) teams in Britain are run entirely by volunteers. The number of MR callouts has increased, partly because teams are increasingly being used by the police in searches for missing people in non-mountainous areas. Most MR teams feel they are coping with the increased demand although some are becoming selective about which call-outs they respond to. A survey of MR team members and potential recruits reveals a mismatch between potential members’ expectation of being engaged in MR and the reality of the increased work supporting non-mountain incidents. This illustrates a potential strain in the motivations of volunteers being used to deliver public services. This article explores how this is particular to the type of volunteering involved in MR, how teams have coped with the increased demand and how the increased use of MR teams is partly a response to changed police management practices.

Brokeback Mountain: Spinal Injuries in Mountain Casualties in Snowdonia

Our emergency department (ED) receives casualties from Snowdonia National Park and surrounding areas. Suspected spinal injuries are common in mountain casualties and pose handling challenges for rescue personnel. The pattern and severity of spinal injuries occurring among UK mountain casualties has not been well studied. Therefore, we wished to establish the incidence and pattern of spinal injuries in mountain casualties presenting to our hospital. Cases with spinal fractures were identified from our database of mountain casualties brought to our ED January 2004 to December 2011 after contact with mountain rescue teams or Royal Air Force Search and Rescue helicopter, or both. Radiological reports and images were reviewed to establish vertebral level and type of injury. Of 789 mountain casualties during the study period, 636 (80%) were injured rather than ill, although 196 had only isolated lower leg injuries. Fifty-one cases had confirmed spinal fractures, including 8 fatalities (17.4% of the 46 trauma fatalities). Most of the spinal fractures (44 of 51) had fallen from a height greater than standing; 20 were direct and 24 were tumbling falls. Most were rock climbing or hill walking at the time of incident. Forty-three of 394 nonisolated ankle trauma casualties (11%) had spinal fractures, but only 7 of 43 were unstable: the unstable fracture rate in casualties found alive was 1.8%. Only 1 survivor sustained spinal cord damage, compared with 5 of 8 fatalities (56%); T12 and L1 together accounted for 43% of spinal fractures. Spinal fractures are quite common in mountain casualties in North Wales. However, only 1.8% of casualties still alive when help arrived had unstable spinal fractures, and only 1 casualty sustained spinal cord injury. Direct falls (eg, rock climbing) produce a similar injury pattern as for urban fallers, but falls of a tumbling nature were associated with a higher rate of cervical and thoracic injury and a greater mortality among fallers with spinal injuries.