Two climbers ascending an icy frozen waterfall with rappelling gear and ropes in a mountainous, snow-covered environment.

Silverton, Colorado, a remote mountain area, has seen a rise in serious emergency calls in the last ten years, particularly in the backcountry. This has created a need for local EMS & SAR programs to work together to offer rescue and medical care to the community.

Silverton Medical Rescue created the Mountain Medicine Symposium to improve education and skills in medical care and rescue in challenging mountain areas. Now, Silverton Medical Rescue, Silverton Avalanche School, the Mountain Medicine Institute, LLC, and the University of New Mexico School of Emergency Medicine have joined forces to offer advanced training in mountain medicine, alpine rescue, and avalanche awareness in one seminar.

Saving lives in extreme environments

Silverton Medical Rescue has operated since 1972, starting as an ambulance service and now providing both emergency medical services and search & rescue for San Juan County, Colorado.

San Juan County has the highest average elevation of any U.S. county and the most avalanche terrain, with numerous avalanche chutes along a main highway. Silverton and the county resemble a national park, attracting year-round tourists for backcountry activities, which present unique logistical & patient care challenges.

Initially an all-volunteer EMT-Basic team, SMR has developed to offer Advanced Life Support along with Technical Rope, Swiftwater, and Avalanche Rescue skills in some of the most challenging areas in the contiguous United States. Before merging with EMS, San Juan County SAR was among Colorado's first teams trained for climbing and avalanche rescues. In October 2016, they joined the International Commission for Alpine Rescue (ICAR).

Group of seven emergency medical services personnel standing in front of two vehicles, one white pickup truck and one mountain rescue truck, outside the Fred Wolfe Memorial Carriage House with snow-capped mountains in the background.
Silverton San Juan County badge with a mountain, snow, and medical symbol

Meet the Speakers
(Past & Present)

  • Pemba Sherpa, CLP

    Pemba first started flying with his commercial pilot’s license back in 1997 in Texas.  He then moved back home to Nepal to work for a private helicopter company, flying tours and high-altitude mountain rescues across the Himalayas of Bhutan and Nepal.  Pemba later returned to the USA in 2014 with his two beautiful daughters and wife to seek a better education for his family.  He has continued flying as a helicopter air ambulance pilot in the western rocky mountains in the time since.  It was only after coming to western Colorado that Pemba discovered a love for hiking, camping, skiing, and ice-climbing.  He is now in his 26th year of flying and enjoys doing it here in the rockies so much that he has no plans to stop anytime soon.

  • Harrison Steins, MS, MS4, FAWM

    Steins began his medical career in New York City's EMS, organizing care for events from Knicks games to Burning Man’s mobile ICU. He then served as Emergency Manager for San Mateo County EMS in California, focusing on disaster response and public health preparedness. A Fellow of the Academy of Wilderness Medicine, he is a final-year medical student at Rocky Vista University in Denver, applying to emergency medicine residencies, while also pursuing a master's in Austere Critical Care in Malta. Harrison enjoys skiing, trail running, surfing, climbing, and mountain biking, and is dedicated to advancing resource-limited medicine research, particularly in austere ultrasound applications.

  • Person in red winter jacket, black helmet, and goggles smiling while holding ski poles in a snowy forest with snow-covered trees and mountain in the background.

    Zach Ryan, OMS IV

    Zach is a fourth-year medical student in the US Army based in Denver. His research focuses on point-of-care ultrasound education and prehospital medicine. Before medical school, he spent seven years as a ski patroller and wildland firefighter, providing medical education. He has held leadership roles in Responder Alliance and conducted mental health first aid training for first responders. In his free time, he enjoys mountain activities, traveling, and spending time with family.

  • David Hughes, MD

    Dr. Hughes is an emergency doctor who started working at Mercy Regional Medical Center in Durango, CO, in 2004 after finishing his residency in Grand Rapids, MI. Soon after, he provided medical guidance for the Upper San Juan ambulance in Pagosa Springs, CO, and enjoyed collaborating with medics. He now works with several agencies and is the medical director for Silverton ambulance, San Juan County SAR, Durango Fire & Rescue, Flight for Life- Durango base, and Purgatory Ski Patrol. He also serves as an EMS liaison for Mercy Regional Medical Center. The stunning high mountain wilderness near the red rock desert attracted him to Durango, and he loves exploring this beautiful area.

  • Tyler George, Director Silverton Medical Rescue

    Tyler was an EMT with Silverton EMS for 4 years before becoming Director. While he lacked the previous director's EMS experience, his BA in Business Administration and business management experience made him a strong candidate. Born and raised in Silverton, he has a deep understanding of the area. From a young age, he learned from top search and rescue and avalanche experts at the St. Paul Ski Lodge. Director George is committed to continuing the previous director's efforts, aiming for excellence in emergency medicine and rescue, and providing San Juan County residents with a reliable Ambulance & Rescue Service they can take pride in.

  • Dr. Justin Grisham FAWM DiMM

    Justin is an Emergency Medicine physician with fellowships in Emergency Ultrasound and Austere/ Wilderness Medicine. Currently he is the ultrasound director and assistant program director of the Kingman AZ emergency medicine residency program and the associate medical director at the Pueblo Community College paramedic program. He is also an instructor for the UIAA/WMS Diploma in Mountain Medicine and teaches both civilian and military wilderness medicine, austere ultrasound, and high angle rock and ice rescue courses. Justin served in the US Army for 8 years as an EM physician in a Forward Resuscitative Surgical Team and as the chief medical officer for 36 critical care paramedics at a combat aviation brigade. He co-authored both the TCCC airway guidelines and the austere snake envenomation guidelines for the US Military. 

    Before medical school Justin was a paramedic, climbing ranger at Mt. Rainier National Park, and a squad leader and chief medical officer with the Salt Lake County Sheriff’s Department’s Mountain Rescue Team where he served as a high angle rescue technician, swift water rescue tech, helicopter rescue tech, and training officer. His interests outside of medicine include paragliding, ice climbing, back country skiing, his slightly insane dog Jasper, and burritos.