Advancedmedicalteambrings lifesavingskillstothebackcountry

JANESEYD Jseyd@nsnews.com

Thereareplentyofplacesinthebackcountrywhere things are more likely to go wrong than right. The backside of Hollyburn Mountain in high avalanche terrainisoneofthem.

It’salsowhereanout-of-boundssnowboarder got caught inanavalancheearlierthismonth,breakinghisleginthe process Though his friend pulled him out, hypothermia begantosetin,justasthelightwasfading.

When things go badly wrong in the North Shore mountains, among the first people heading in are members of North Shore Rescue’s advanced medical provider resource team Made up of 12 emergency room or ICU doctors, anesthesiologists and a nurse, the team combines advanced emergency medical skills with experienceandtraininginbackcountrymountaineering. Medical personnel on the team also must live on the North Shore, so they can be ready to head out at a moment’snotice

Of the 12 people currently on the team, seven doctors and one nurse work regular jobs at Lions Gate Hospital, while four doctors work out of Royal Columbian in New Westminster

Dr Alec Ritchie and registered nurse Kayla Brolly are team leaders of the medical resource team who are both alsoregularmembersofNorthShoreRescue

“The common denominator for all the AMPs is we’re all mountainpeople,”saysRitchie “Sowe’reallcomfortable onskis,orcramponsorropesandthatsortofthing.”

Ritchie, an emergency department doctor who is also a professor of emergency medicine at UBC, is also part of theWhistlerskipatrolasanembeddedphysician Brolly, who grew up on the North Shore, also spent time as a ski patroller before becoming a rapid attack forest firefighter, where she rappelled out of helicopters into danger. When she started nursing school at UBC, Brolly decidedtovolunteerwithNorthShoreRescueasawayof continuingtouseherskills Shehasn’tlookedbacksince, including providing medical help at an NSR SAR station twodaysbeforegivingbirthtoherdaughter

”THECOMMONDENOMINATORFOR ALLTHEAMPSISWE’REALLMOUNTAIN PEOPLE.SOWE’REALLCOMFORTABLE ONSKIS,ORCRAMPONSORROPES ANDTHATSORTOFTHING.”

About40percentofNorthShoreRescuecallsaremedical calls.Ofthose,about25to30percentareserious.Itcould be a serious bone fracture, chest pains, a heart attack, someonewhoisfallingunconsciousorshowingsignsof acollapsedlungorinternalbleedingafterafall

Sometimes there’s a mental health issue – someone’s drunkorhigh,paranoidorsuicidal Thereisno“typical”call.

But just as an example, says Ritchie, consider the “boot top tib/fib fracture” – what happens if a skier falls over and snaps their leg at the top of their ski boot “Sometimes the bone’s even sticking out of the skin ThenputyourselfinthebackcountryofSeymour” down to a doctor or nurse’s own clinical skills “When you’rethere,youhavetomake whateveryouhavework,”says Ritchie.

The advanced medical provider program is unique in Canada.InEurope,suchteamsaremuchmorecommon, said Ritchie – with one big difference. “In Europe you’re a paid professional That is your job, to do helicopter mountainmedicine Wejustdoitforfree”

Today, their capability rivals any search team in the world

“We have the medications and the equipment to essentiallybringanintensivecareunittothemountains.”

Among the equipment they often carry: monitors, a defibrillator, a CPR machine that does chest compressions, oxygen, IV tubing, breathing tubes and evenahandheldportableultrasound

Beyond the technical gear and medications, knowing as muchaspossibleaboutwhatthey’rewalkingintohelps.

Once in the field, however, a lot of critical care comes

Emergency medicine on the sideofamountainslopeinthe dark will never be the same as it is in hospital “When the technical complexity of the mission increases, the medical care must decrease Something has to give,” says Ritchie “If they’re on the side of the mountain on ice and it’s -10 and we’re helicopter longlining, that’s a technical mission. I can’t be doing a lot of medicine. I must stabilize the patient and get out of Dodge.”

“There’s a lot of medical decisionmakingonwhatdoweneedtodoimmediatelyand what can wait until we get to somewhere warmer, drier, betterlit.”

Brolly points to a call in September as one where the medicalteammadeallthedifference Inthatcase,Brolly used a portable cardiogram to diagnose a major heart attack in a hiker suffering severe chest pains at the top ofMountStrachan Knowingcardiacemergenciesshould be handled at certain specialist hospitals, they flew the man straight into Vancouver Harbour for transfer to St Paul’sER

“That’sacasewherethisprogramismakingadifference,” she said. “If it was 10 years ago and we didn’t have this technology and this level of care, it could have gone a differentdirection.”

On behalf of West Vancouver-Capilano constituents, we thank the skilled members of North Shore Rescue for volunteering your time and energy to keep us safe all year round.

Not every call is a success “Not everybody lives,” said Ritchie “That’shardonus”

Deaths that result from foolish decisions are especially difficult,hesaid,because“thisdidn’tneedtohappen.”

But those days are far outweighed by the satisfaction of makingadifferenceinanenvironmenttheylove

“It’s very gratifying,” says Brolly “Because you’re in these really bad spots with people where no one else is coming It’sjustyouandyourteam”

- Jordan