2025 International Mountain Medicine Symposium Topics

• Spinal Cord Protection, David Hughes, MD
  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.

• Frostbite - Updated In-Field and Hospital Treatment, Scott McIntosh, MD
  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.

• High Altitude Illness, Prevention and Treatment, Will Smith, MD
  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.

• Mountain Medicine – Where Ambulances Can’t Go, Will Smith, MD
  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.

• How to Build Your Career in Wilderness Medicine – My Story from A to Z, Will Smith, MD
  Paramedic Physician Will Smith describes how his career has progressed over the past 30 years from becoming an EMT in High School to now having practiced medicine on 6 continents from ‘Baghdad ER’ to Easter Island. He shares his experience and tips that have created many opportunities to practice medicine in unique places and strategies for networking and advancement within the wilderness medicine community.

• Travel Medicine Considerations for the International Outdoor Athlete, Jay Mathers, DO
  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 1986 Mount Hood Disaster: Hypothermia, Mountain Rescue, and Decision- Making in the Outdoors, Alex Franke, MD
  A talk about the 1986 Mt Hood Disaster, with highlights including the most up-to-date management of hypothermia, evolution in mountain rescue techniques over the last 40 years, and what this disaster can teach us about decision making both as medical professionals and recreationalists.

• Mistakes I've Made: Avoidance and Management of Lightning Injuries, Alex Franke, MD
  A discussion regarding management of lightning in the wilderness including strategies for avoidance, and the forthcoming updated WMS guidelines for lightning injuries.

• Compartment Syndrome: The Importance of Early Recognition- Causes, Diagnosis, Treatment, Kim Furry, MD
  Understanding the concerning mechanisms of injury and the importance of early recognition, signs and symptoms, and also treatment of compartment syndrome. Improve understanding of mechanism of injury, associated injuries, as well as signs and symptoms. Highlight the importance of early recognition, consequences of misdiagnosis and the treatments available for compartment syndrome.

• Pain management in the Backcountry, Brendan Lutz, MD
  Discussion of optimal pain management solutions in the wilderness. Applying multimodal pain control practices to the backcountry.

• Pediatric Considerations in Mountain Medicine, Benny Chen, MD
  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.

• Canyoning 101 for Climbers, Benny Chen, MD
  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.

• Developing Critical Thinking in You and Your Staff, Shane Baird, EMT-P
  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.

• Backcountry Comms, Shane Baird, EMT-P
  Communications are mission critical for any operations in the backcountry. However, the austere environment also poses unique challenges to communication. In this course, we will examine the fundamentals of communications, explore the primary tools used, and cover several different paradigms to improve operational communications in the backcountry.

• Backcountry GI Illness, Joshua Marcum, DO
  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.

• Endurance Athlete Ailments, Joshua Marcum, DO
  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.

• Immersion Pulmonary Edema, Kathryn Vidlock, MD
  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.

• Austere Ultrasound for the Primary Assessment: Why Guess When You Can Know?, Justin Grisham, DO

  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.

• CPR in Toboggans, Lindsey Fell, MD
  The epidemiology of cardiac arrest in out-of-hospital, winter environments reveals unique challenges due to extreme cold and remote locations, which can complicate timely intervention. Potential risk factors for cardiac arrest in austere environments include hypothermia, physical exhaustion, altitude-related stresses, and delayed access to advanced medical care. Effective management of cardiac arrest in ski patrol and backcountry settings requires specialized training in alpine rescue techniques, the use of portable defibrillators, and adherence to protocols adapted for harsh weather and terrain, ensuring prompt and appropriate care despite environmental limitations.

• Austere Psychiatric Emergencies: From De-escalation to Droperidol, Greg Doctor, MD
  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.

• Pragmatic Wilderness Medicine, Greg Doctor, MD
  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.

• Hemorrhage Control in the Field, Shane Baird, EMT-P
  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.

• Heat Illness Management in the Austere Setting, David Cabaniss, MD
  This lecture covers current methods for managing heat illness in austere settings, emphasizing practical techniques to treat conditions ranging from heat exhaustion to heat stroke using commonly available resources. Remote environments pose unique challenges, as rapid evacuation and advanced medical care are often not options, yet many providers lack up-to-date training on identifying and managing the full spectrum of heat-related illnesses during prolonged field care. The session aims to equip wilderness medical providers with the knowledge, clinical judgment, and improvisation skills needed to effectively recognize, treat, and prevent heat illness in these challenging settings.

• Altitude and Aging: Chronic Illness and Geriatric Care in Mountain Emergency Medicine, Aaron Reilly, DO
  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.

• Cardiac Arrest in the Field, Angela Martz, PA-C
  A case study of out-of-hospital cardiac arrest treated by EMS highlights the critical role of rapid response, early defibrillation, and effective CPR in improving patient outcomes. Literature review indicates survival rates vary widely but generally remain low, emphasizing the need for optimized pre-hospital care. Best practices include immediate recognition of cardiac arrest, prompt initiation of high-quality chest compressions, timely defibrillation, and coordinated post-resuscitation care to enhance survival and neurological outcomes.

• Psychological Safety & Resilience in the Wild: Thriving Under Pressure in the Austere Environment, Kim Furry, MD
  The session includes a 50-minute presentation and small group discussions, followed by a 10-minute Q&A. It will define psychological safety and resilience within wilderness medicine, identify barriers to psychological safety in challenging environments, and teach practical tools to build resilience before, during, and after stressful situations. Participants will leave with 2–3 simple, low-resource strategies to support team cohesion and mental wellness in the field.

• “Take My Breath Away” Successful Surgical Airway Management in the Austere Setting, Ryan Hodnick, DO
  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.

• The Silverton Stress-Test: Rarified Complications of Medical Conditions,Ben Stone, FP-C

  A discussion spanning diseases such as Cardiomyopathies, Coagulopathies, and Genetic Diseases, all of which we’ve seen triggered, exacerbated and complicated at higher elevations.

• Caring for Man’s Best Friend: K-9 Care for Non-Veterinary Providers, Ryan Hodnick DO
  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.

• “MacGyver” in the Mountains: Improvised Medical Skills, Darryl Macias, MD
  This will be a continuation of "MacGyvering in the Mountains," where additional practical tips for improvised medicine will be given, using the MARCH algorithm. "Tried and true methods" will be examined under the scrutiny of the literature, to determine whether techniques used for the initial stabilization of a patient is fact, or fiction.

• BLS Airway Management with a Focus on Nuanced BVM Technique, Chris Berger
  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.

• Prolonged Field Care in Mountain Rescue, Darryl Macias, MD
  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.

• Avalanche Resuscitation, Lindsey Fell, MD
  The session begins with a lecture covering the fundamentals of avalanche mechanics, burial, scene safety, and basic search strategies, followed by practical time to apply these skills. Emphasis is placed on avalanche extraction techniques and the initial assessment and resuscitation of victims, highlighting avalanche-specific considerations throughout.

• Splinting in the Backcountry, Angela Martz PA-C & Kim Furry, MD
  An interactive demonstration and hands-on workshop of splinting as well as patient management

• Austere Ultrasound- Hard Conclusions from Soft Tissues, Harrison Steins MS4, EMT & Zachary Ryan
  The baseline assessment will be evaluated by a pre-course group practice quiz with included ultrasound images, clinical scenarios, and clinical decision making questions and examined to ensure proficiency at the end of the workshop. Current practice has shown limited trials in shortened (<10 hour) ultrasound courses for pre-hospital providers however new research is arising and new peer-reviewed evidence is available to demonstrate the effectiveness of the course, and the instructor will continue to assess the effectiveness of closing the gap between the baseline assessment and the standard with this workshop. Portable Ultrasound is an emerging imaging modality in the pre- hospital and mountain environment due to its ease of use, cost, portability, and effectiveness and can elevate the care of patients in resource limited environments around the world.

• Patient Prep and Packaging for Heli Operations in the Wilderness Millieu, Robbie Klimek, FP-C
  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.

  
  And more to be posted with the official schedule!