Symposium Day 1
Friday, September 19, 2025

  • OPENING: The 1986 Mt. Hood Disaster: Hypothermia, Mountain Rescue, & Decision-Making
    Faculty: Dr. Alex Franke
    Friday Sept.19, 8:30-9:15am
    45 minutes
    Practice GAP: Austere medical providers (Physicians, PAs, NPs, Paramedics, EMTs) lack the skills to perform a primary assessment utilizing handheld ultrasound. This lecture will provide basic instruction and information in the utilization of handheld ultrasound in the austere environment for primary assessment and re-assessment of the critically injured patient. Evidence has shown that traditional primary assessment skills are limited in their accuracy. This is compounded in the austere environment that is often very bright or very dark, loud, and does not always allow for complete exposure of the patient. Many medical providers have not been provided with the ultrasound skills or knowledge necessary to perform a primary assessment or reassessment because it is not a standard practice or part of the curriculum for many programs.

  • Prolonged Field Care in Mountain Rescue
    Faculty: Darryl Macias MD
    Friday Sept.19, 9:30-10:15am
    45 minutes
    The core tenets of prolonged field care (PFC) will be discussed in terms of a traumatic injury in the mountains, in a case based format, emphasizing the mnemonic "MARCH PAWS Leave" for the first 24 hours in the field. Specifically, an augmentation of the MARCH algorithm will be reformatted to include M (massive hemorrhage/mass casualty/monitors) A (airway care), R (respiratory care), C (circulation, communication, crossmatch), H (hypothermia, hyperthermia, head injury), P (pain control), A (antibiotics), W (wounds and burns), S (splints, orthopedics, self-care) and Leave (logistics and evacuation plan). Salient tips practical for the mountain rescue specialist will be given.

  • Heat Illness Management in the Austere Setting
    Faculty: David Cabaniss MD
    Friday Sept.19, 10:30-11:15am
    45 minutes
    This lecture covers practical ways to manage heat illness in remote, resource-limited settings. It focuses on hands-on treatment methods for conditions from heat exhaustion to heat stroke using common items found in these environments.Remote areas pose challenges for treating heat illness because quick evacuation or advanced care is often not possible. Many providers lack training on how to identify and manage heat problems like heat cramps, heat exhaustion, and heat stroke during extended field care. This session aims to give wilderness medical providers the skills and knowledge to recognize, treat, and prevent heat illness using simple, improvised methods.

  • Altitude and Aging: Chronic Illness and Geriatric Care in Mountain Emergency Medicine
    Faculty: Aaron Reilly DO
    Friday Sept.19, 10:30-11:15am
    45 minutes
    This lecture will focus on how chronic illness and advancing age affect physiology, adaptation, and the approach to emergency management in remote and high altitude environments.

  • CPR in Toboggans
    Faculty: Lindsey Fell MD
    Friday Sept.19, 10:30-11:15am
    45 minutes
    - Epidemiology of cardiac arrest in out-of-hospital, winter environments
    - Potential risk factors for cardiac arrest in austere environments
    - Management of cardiac arrest in ski patrol and backcountry environments - Prior studies evaluating quality of CPR in moving toboggans
    - Future research, potential applications

  • Immersion Pulmonary Edema
    Faculty: Kathryn Vidlock MD
    Friday Sept.19, 11:30-1:00pm
    90 minutes
    Immersion Pulmonary Edema, more specifically Swimming-Induced Pulmonary Edema (SIPE), is an often underrecognized yet significant cause of morbidity and mortality among open water swimmers and scuba divers. This session will provide a comprehensive review of current evidence and emerging research related to SIPE. It will also introduce a practical diagnostic and treatment framework, including hands-on instruction in the use of the BLUE protocol with handheld ultrasound devices.

  • Splinting in the Backcountry
    Faculty: Angela Martz PA-C, Kim Furry MD
    Friday Sept.19, 11:30-1:00pm
    90 minutes
    An interactive demonstration and hands-on workshop will cover splinting techniques and patient management, including discussions on orthopedic management in austere environments. Participants will practice upper and lower extremity splinting in wilderness settings, conduct assessments of extremities with fractures, learn proper patient packaging with a splint, and gain skills in using SAM splints effectively.

  • Caring for Man’s Best Friend: K-9 Care for non-veterinary providers
    Faculty: Ryan Hodnick DO
    Friday Sept.19, 11:30-1:00pm
    90 minutes
    Talk will explore the basics of caring for our working four legged companions and performing basic and lifesaving interventions. Lecture with demonstration of a physical exam on a working avalanche rescue trained dog volunteer.

  • Hemorrhage Control in the Field
    Faculty: Shane Baird EMT-P
    Friday Sept.19, 1:15-2:00pm
    45 minutes
    In the last ten years, EMS has seen fundamental changes in the best practices of bleeding control. Old tools like tourniquets have joined new ones like hemostatic gauze and tranexamic acid in the arsenal of providers. At the same time, new prescription anti-coagulant medications have changed the landscape of bleeding control. In this presentation we will describe the physiology behind bleeding and clotting and contextualize the available tools in field practice.

  • Pragmatic Wilderness Medicine
    Faculty: Greg Doctor MD
    Friday Sept.19, 1:15-2:00pm
    45 minutes
    As backcountry medical providers, we are constantly balancing the burden of a heavy pack with the risk of being under-resourced. You can't bring your CT scanner on El Cap, but you can develop a solid understanding of how to use what you have on hand to actually make a difference. Empty your cargo pockets and flex that brain muscle. From MacGyver hacks to high yield maneuvers, we'll cover how to make a difference in low resource, austere settings. Start building out your list of "cheat codes" for backcountry emergencies.

  • BLS Airway Management with a Focus on Nuanced BVM Technique
    Faculty: Chris Berger, Paramedic
    Friday Sept.19, 1:15-2:00pm
    45 minutes
    In the course we will cover the foundation of care for all critical patients, BLS Airway Management. Many patients can be managed well with excellent BLS management and those that need advanced intervention will respond better to the advanced care with good initial BLS care.
    Expect to think critically about the small details in equipment and care that are often overlooked but can make a huge difference on patient outcome.
    Practice Gap Statement: Despite initial training, many EMS providers at the BLS and ALS level demonstrate variable proficiency in airway management, particularly with effective use of the bag-valve-mask (BVM) device. This deficiency becomes more pronounced in austere and wilderness environments, where access to advanced airway equipment and backup support is limited, transport times are prolonged, and environmental conditions are suboptimal.

  • Pain Management in the Backcountry
    Faculty: Brendan Lutz MD
    Friday Sept.19, 2:15-3:00pm
    45 minutes
    Discussion of optimal pain management solutions in the wilderness. Applying multimodal pain control practices to the backcountry.

  • Cardiac Arrest in the Field
    Faculty: Angela Martz PA-C
    Friday Sept.19, 2:15-3:00pm
    45 minutes
    -Case study review of cardiac arrest out of hospital, with EMS based treatment -Literature review of survival rates of out of hospital cardiac arrest
    -Best practices for managing cardiac arrest and sudden cardiac events out of hospital

  • Compartment Syndrome: The Importance of Early Recognition- Causes, Diagnosis, Treatment
    Faculty: Kim Furry MD
    Friday Sept.19, 2:15-3:00pm
    45 minutes
    Understanding the concerning mechanisms of injury and the importance of early recognition, signs and symptoms, and also treatment of compartment syndrome.

    • Historical perspective

    • Pathophysiology

    • Etiology

    • Diagnosis

    • Treatment

    • Lower extremity

    • Upper extremity

  • Endurance Athlete Ailments
    Faculty: Joshua Marcum DO
    Friday Sept.19, 3:15-4:15pm
    60 minutes
    From Leadville to the Tour Divide, endurance events continue to increase in popularity as well as length. As humans push themselves further, unique challenges present themselves. We'll dive into the effects on the human body of pushing for days on end as well as prevention and treatments.

  • Austere Psychiatric Emergencies: From De-escalation to Droperidol
    Faculty: Greg Doctor MD
    Friday Sept.19, 3:15-4:15pm
    60 minutes
    Are you ready to talk someone off a literal cliff? What is your plan for the hulk sized 19-year-old who took too many mushrooms on a river trip and thinks he is God? This course will help you develop a structured yet fluid approach to dealing with acute agitation, psychosis, or intoxicated patients in austere environments. We review best practices in verbal de-escalation, when to utilize sedating medications, and what medications to use.

  • “Take My Breath Away” Successful Surgical Airway Management in the Austere Setting
    Faculty: Ryan Hodnick DO
    Friday Sept.19, 3:15-4:15pm
    60 minutes
    Course will explore the fundamental aspects of the most important airway procedure as well as barriers to its success. Course will include hands-on training and will help the learner successfully perform this essential airway management technique anywhere anytime.

  • Mistakes I've Made: Avoidance and Management of Lightning Injuries
    Faculty: Alex Franke MD
    Friday Sept.19, 4:30-5:30pm
    60 minutes
    A discussion regarding management of lightning in the wilderness including strategies for avoidance, and the forthcoming updated WMS guidelines for lightning injuries.