Launch party of the NZ Society for Mountain Medicine
February 18, 2020
March Has Been A Long Month
April 1, 2020

A "classic" Scottish day out on Annoch More, Lochaber

“Och Aye!”

A “classic” Scottish day out on Annoch More, Lochaber

A popular Scottish expression, meaning “Oh yes!”

 It was with some excitement that I (Robin)  headed to Fort William, Scotland at the end of February to complete an instalment of the UK, Diploma in Mountain Medicine (DiMM).  Unlike in the Game of Thrones, Winter had finally arrived. 

 In fact there had been so much new snow driven by backing gale force winds that the avalanche forecast on my first day out in the mountains, demanded attention and careful route choice (see forecast below).  To quote a guide I spoke to later in the day,  “It isn’t often that 4 segments of the avalanche rose have a ‘high’ rating, with a further 2 segments having a ‘considerable’ rating!”  Though this day was exceptional, the cold, snowy and windy conditions dominated most of the weeks activities.

The DiMM module was six days long and designed to teach and sharpen mountain skills, with the idea being that it’s pointless having doctors, nurses and paramedics practicing in the outdoors if they can’t look after themselves.  Fortunately, the weather played ball making training conditions pretty ‘realistic’ at times.  We had no trouble finding challenging navigational problems, and substituting the exploration of large cornices (on a safety rope) as standing in for simulated crevasse fall and rescue.  In addition to hard mountain skills most every day also featured some kind of medical scenario – just to keep you on your toes and remind you why you were really there …  The mountain skills training included;

  • winter navigation
  • avalanche understanding / assessment
  • route planning
  • winter rope techniques / crevasse rescue
  • emergency snow shelters
  • practical avalanche scenario

Searching for avalanche victims and administering ALS

Thankfully, the course instructional team were all IFMGA guides, with decades of experience between them.  Unsurprisingly, they also came with there own selection of survival stories to add  a degree of context to the teaching (!)  Some of the guides had worked Scottish winters for 20+ seasons consecutively!

Like all courses that go well, it’s the chemistry of having some good planning, combined with positive vibes from faculty and participants alike that make for a magic time.  Indeed, and that  was definitely the case on this course, where everyone was psyched everyday.   

My big takeaways from the week were linked to the avalanche training and scenarios we did.  Like other mountain skills, e.g.  ice axe braking, navigation etc …  avalanche rescue is significantly more effective and efficient with regular practice!

Certainly,  once you understand some of the stats around avalanche fatalities, you realise your best chances lie with; a) avoidance, b) self rescue and c) others in your party being proficient with transceivers and avalanche rescue techniques.  So with this in mind we practiced searching for buried transceivers on the course, and like anything the more you did it the better you got at it.  In the same vain, I can now see the huge benefit of practice at an avalanche transceiver park, to refine your transceiver use and search technique.  (Here is a link to the park at the Scottish National Outdoor Training Centre at Glenmore Lodge, where it is free to use by the public.  The webpage also contains some excellent resources on how to use the park, transceiver searching, shovelling techniques and some avalanche footage (and lucky survivors)).

I was also reminded of the importance of being organised – not only in terms of personal  outdoor competence, but specifically for avalanche rescue.  The pics show a laminated checklist produced by the DiMM lead guide, Graham McMahon, (who has decades of experience ski guiding in the European Alps).  This simple ‘aide memoir’ ensures that things don’t get forgotten in the rush to help.  For example, nominating a leader, switching transceivers off among the rescuers, turning off victims transceivers (when found) etc…    Similarly, having the search diagrams ensure searches are done thoroughly and victims don’t get missed in stressful situations.  Graham borrowed the images from a helpful website called beaconreviews.com.  Which, as it suggests discuss the merits of the dozens of different avalanche transceivers models and manufacturers out there. 

 

 

Know your transceiver!   There are so many models with so many features, one can easily get confused when they need to be used in anger. Having had the chance to practice with a few different models I would now try and get one with a ‘mark’ function, which makes the search process considerably easier. 

Lastly, only once you have used the ICAR, Avalanche Victim Resuscitation Checklist in earnest does it begin to make more sense. I would strongly suggest getting a small laminated version to carry onto the mountain with you, if this is something you want to get right.  Or, perhaps download the PDF to your mobile, which you might need to keep in a Faraday bag to prevent it causing transceiver interference.   

In fact, understanding avalanche triage, reasons for the various stages, and applying advanced life support to victims in these situations will be the subject of another blog entry in its own right.

 Dr Robin Barraclough

 

 With thanks to the UK DiMM Module lead Dr Ben Warwick and the rest of the medical faculty, as well as Lead guide Graham McMohon and the rest of the guiding team.

The Fiacaill ridge, Cairngorms in mint conditions

References:

Avalanche Victim Resuscitation Checklist adaption to the 2015 ERC Resuscitation guidelines.  https://www.resuscitationjournal.com/article/S0300-9572(17)30020-5/fulltext

 

Resuscitation of avalanche victims: Evidence-based guidelines of the international commission for mountain emergency medicine (ICAR MEDCOM) (Intended for physicians and other advanced life support personnel).  

https://www.resuscitationjournal.com/article/S0300-9572(12)00876-3/fulltext

 

 

 

 

 

 

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