High Altitude Illness, Prevention and Treatment
Faculty: Will Smith MD
Saturday Sept.20, 8:30-9:15am
45 minutes
High Altitude Illness (HAI) occurs when individuals ascend to altitudes typically above 2,500 meters (8,200 feet) without proper acclimatization. This presentation covers the physical impacts of high altitude, types of altitude-related illnesses such as Acute Mountain Sickness (AMS), High Altitude Pulmonary Edema (HAPE), and High Altitude Cerebral Edema (HACE), as well as their prevention and treatment strategies. The symptoms of HAI can range for mild headaches and dizziness to life-threatening conditions requiring immediate intervention. SAR medical response to high altitude must incorporate all the technical aspects of altitude travel, treating the spectrum of HAI, as well as other medical/traumatic emergencies that occur. Discussions from case studies and real-life experiences will examine the spectrum of HAI and underscores the importance of self/team preparation and education for those responding and treating high altitude emergencies.

Frostbite - Update in Field and Hospital Treatment
Faculty: Scott McIntosh MD
Saturday Sept.20, 9:30-10:15am
45 minutes
Frostbite is a medical concern for backcountry travelers in the winter environment. Prevention is the key to reduce morbidity from frostbite. New treatment modalities have emerged in the United States in the past 2 years that require education of mountain medical providers. This talk will discuss the spectrum of frostbite: prevention, physiology, and treatment strategies. We will discuss actual cases and the nuances of when/when not to thaw, which medications are beneficial to help salvage at-risk tissue, and when to send to a frostbite-receiving hospital. We will practice hands-on how to bandage injuries to ensure best outcomes.

Pediatric Considerations in Mountain Medicine
Faculty: Benny Chen MD
Saturday Sept.20, 10:30-11:15am
45 minutes
As general participation in outdoor recreation increases annually, so do the number of children that venture out into austere environments. Comprising a substantial segment of SAR operations, the pediatric population requires unique considerations in the discipline of mountain medicine. Following this session, the participant will engage in exploring the pediatric challenges in austere alpine environments; review the physiologic differences as they relate to acclimatization, equipment, trauma, and energy expenditure; develop a framework for addressing pediatric patient needs in mountain medicine.

Austere Ultrasound- Hard Conclusions from Soft Tissues
Faculty: Harrison Steins MS4, EMT and Zachary Ryan MS4
Saturday Sept.20, 11:30am-1:30pm
120 minutes
This project aims to equip austere and wilderness medical providers with critical ultrasound skills to enhance diagnostic accuracy and procedural safety in resource-limited environments. Through targeted instruction and hands-on practice, participants will develop proficiency in high-yield point- of-care ultrasound (POCUS) applications relevant to emergency and field medicine. Training modules will include: Ultrasound-Guided Foreign Body Removal, Soft Tissue Ultrasound for Cellulitis vs. Abscess vs. Pseudoaneurysm, Ultrasound-Guided Field Nerve Blocks, and Early Identification of Necrotizing Fasciitis.

This project supports the development of sustainable ultrasound capacity in remote environments through low-cost, high-impact training, empowering providers to make timely, accurate decisions in the absence of advanced diagnostics.

Avalanche Resuscitation
Faculty: Lindsey Fell MD
Saturday Sept.20, 11:30am-1:30pm
120 minutes
An initial lecture with time after to practice:

• Basics of avalanche mechanics and burial

• Avalanche scene safety

• Basic avalanche search strategies

• Avalanche extraction

• Focus on the initial assessment/resuscitation with attention to avalanche-specific considerations

• Evacuation/rescue considerations from an avalanche scene

Patient Prep and Packaging for Heli Operations in the Wilderness Milieu
Faculty: Robbie Klimek FP-C
Saturday Sept.20, 11:30am-1:30pm
120 minutes
Prehospital helicopter patient packaging seems simple, but doing it properly when a life is on the line during hot operations takes skill, artistry and a grasp on physiology of the human body. In this hands-on demonstration we'll learn how to prep and package with the help of our own helicopter present to help instill these lessons.

Spinal Cord Protection
Faculty: David Hughes MD
Saturday Sept.20, 1:45-2:30pm
45 minutes
As we move away from the impractical idea of spinal immobilization and focus on spinal cord protection, how does this translate to the management of the injured patient who requires extrication from the backcountry setting?
This presentation discusses a critical thinking approach to treating and transporting patients who have suffered high-mechanism trauma in the backcountry, with possible spinal injury.

Canyoning 101 for Climbers
Faculty: Benny Chen MD
Saturday Sept.20, 1:45-2:30pm
45 minutes
Canyoning and canyoneering are growing sports in North America. At present, there is limited literature, infrastructure, and familiarity with these endeavours, in comparison to the robust protocols and best practices seen in climbing. Following this session, the participant will learn how to best recognize canyon anchors and systems, and how to secure them; develop an understanding of canyoning related injuries; analyze the unique environmental and equipment risks involved in the sport, in the context of better affecting rescues.

Backcountry GI Illness
Faculty: Joshua Marcum DO
Saturday Sept.20, 1:45-2:30pm
45 minutes
Bubble guts? Feeding the fish? Innocuous looking water can ruin a trip. Learn whether that crystal clear pool is safe to drink, current treatment techniques, and what to do if you've ended up a bit green around the gills.

Developing Critical Thinking in You and Your Staff
Faculty: Shane Baird EMT-P
Saturday Sept.20, 2:45-3:30pm
45 minutes
The term "Critical Thinking" is overused and misunderstood in EMS. It is held as an aspirational goal, used as a professional assessment tool, and applied as a benchmark for critiquing performance. But what does it actually mean? Many, if not most EMS providers would probably struggle to define the term if asked. How can a concept be so ubiquitous, yet undefined? In this session, we will attempt to illustrate the concept of critical thinking in a practical manner. We will use concepts such as Confirmation Bias, Idea Attachment, and the Gambler's Fallacy to illuminate the obstacles to critical thinking. Finally, we will apply what we have learned to create a practice of critical thinking.

Travel Medicine Considerations for the International Outdoor Athlete
Faculty: Jay Mathers DO
Saturday Sept.20, 2:45-3:30pm
45 minutes
This will cover travel medicine concepts to consider for the international outdoor athlete for mountaineering and climbing expeditions, adventure racing, jungle treks, and whitewater adventures to name a few. This lecture will discuss the topics of pre-trip vaccinations, travelers' diarrhea, altitude preparedness and treatment, wound care, and other international travel concepts for people participating in international travel vacations. This will cover specific regions globally and the considerations for each region regarding topics in travel and wilderness medicine while adventuring in austere environments internationally.

The Silverton Stress-Test: Rarefied Complications of Medical Conditions
Faculty: Ben Stone FP-C
Saturday Sept.20, 2:45-3:30pm
45 minutes
Description: A discussion spanning diseases such as Cardiomyopathies, Coagulopathies, and Genetic Diseases, all of which we’ve seen triggered, exacerbated and complicated at higher elevations. Objectives:

Austere Ultrasound for the Primary Assessment: why guess when you can know?
Faculty: Justin Grisham MD
Saturday Sept.20, 4:45-5:30pm
60 minutes
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. 

Mountain Medicine – Where Ambulances Can’t Go
Faculty: Will Smith MD
Saturday Sept.20, 4:45-5:30pm
45 minutes
Mountain medicine tailors traditional medical skills and applies them to the wilderness and other austere settings. Search and Rescue (SAR) has many realms that bridge the Technical Rescue Interface – Where Ambulances Can’t Go. This case study based lecture discusses the many realms of Search and Rescue (swiftwater, high angle, cave, avalanche, etc.) as well as other remote care settings and discusses medical adaptations that must be made in each to optimize patient care and minimize risk to the patient and rescuers.