March 25, 2004
Mike Kiley, PhD
Ben Honea, MD
Colorado Alpine Advanced Trauma Care Project, Inc.
1261 Trail Ridge Road
LongmontCO 80501
Dear Drs. Kiley and Honea:
Your efforts to establish the Colorado Alpine Advanced Trauma Care Project recently came to my attention. As a national membership organization with more than 7,000 members, including close to 900 who live in the Colorado Front Range, The American Alpine Club is keenly interested in ensuring that climbers facing backcountry medical emergencies receive the best care possible. For this reason, the AAC thanks you for your efforts to add more, highly trained emergency care providers to the search and rescue system in Colorado.
At first blush, however,it appears your efforts seek to address a very specific type of backcountry accident—one in which the victim has critical injures requiring advanced lifesaving skills and where the victim is located in an area in which the only means of access is via a technical climbing route from below. I do not have data spelling out how many of these incidents exist in Colorado or the rest of the nation, but general trends indicate they would be exceedingly rare.
To begin with, climbing rescues represent a very small share of all backcountry rescues. National Park Service data from 2002—the last year available—indicate that climbing accounted for only 5.3 percent of all search and rescue missions system wide, well below the number of rescues provided for other groups including hikers, boaters and swimmers. Climber rescues also are such a small percentage of Colorado rescues that they are not tracked separately in Colorado Search and Rescue Board statistics, again overshadowed by other recreational groups, including hikers, hunters, skiers and fishermen. And, of the relatively few climbing-related rescues, it is unclear how many involve technically demanding terrain (i.e. 5.10+) in which the only means of access is via the rescuer climbing up from below. Usually, even the most difficult-to-reach accident sites can be reached by helicopter or by inserting a rescue team from less technical terrain, often from above.
For more than 55 years, the American Alpine Club has published “Accidents in North American Mountaineering,” an annual account of climbing accidents in the U.S. and Canada. Within these climbing-related rescues—which again represent a very small share of all backcountry rescues—many are for lost parties or accidents with less-than-life-threatening injuries. While having skilled paramedics on a climbing-related rescue may improve patient care, it may not significantly improve the patient's outcome. Given the remote locations of many climbing accidents, life-threatening injuries likely will have stabilized themselves with only the intervention of party members on scene during the time it takes to alert authorities and get rescuers to the accident site. Thus, the addition of paramedics alone may not change the outcomes of most climbing accidents.
There may be a day when having a paramedic on scene who can lead technical rock may change the outcome of a climbing accident, and I'm sure that climber will be grateful to have such a person on scene. However, it seems that your approach is focused on developing a highly specialized response for a very specific (and equally rare) event. More general steps—for example, encouraging paramedics (even those who aren't climbers) to get involved in mountain rescue groups or encouraging skilled climbers to become certified in wilderness first aid/wilderness first response—may bring a more significant benefit, not only to climbers, but more importantly, to the larger number of other backcountry recreationalists.
Again, good luck on your project. I am interested to know how many Colorado paramedics are technically proficient climbers who are interested in participating in mountain rescues. Please keep me posted as your project progresses.
Regards,
Lloyd F. Athearn
Deputy Director