Jennings: Physician’s input bolsters Mount Spokane Ski Patrol
Operating a ski area is akin to growing crops: Both are at the mercy of the weather.
While farmers till their fields, mountain managers groom their snow. There’s little groomed snow around here. A parade of Pacific storms has brought a bounty of rain. Farmers can put that in the bank. But as the latest Pineapple Express blows by, ski area operators are watching critical early-season cash blow away along with it.
When the weather finally allows Inland Northwest ski areas to gear up for regular-season operations, the lifts can’t turn without their ski patrols in place. Fortunately, these groups of trained emergency responders aren’t an operating expense. An exception is Schweitzer, where patrollers are paid. Everywhere else, each ski patrol member pays with hundreds of volunteer hours every season so mountains may open.
Before they can donate their time for our pleasure, ski patrollers spend several hundred hours training to become qualified as OEC (Outdoor Emergency Care) technicians. Once they become qualified, the training never ends. When you see someone wearing a red jacket with a white cross on their back, you’re looking at the equivalent of an EMT (Emergency Medical Technician) on skis.
Technically, and legally, the Mount Spokane Ski Patrol (MSSP) is in the business of “pre-hospital health care delivery.” As a local healthcare organization, it is bound to follow guidelines written by the Spokane County EMS Council, a nonprofit corporation that supports a comprehensive emergency care system.
The Spokane County EMS Council issues evidence-based protocols that OEC volunteers follow as they work in partnership with EMS professionals, such as EMTs and firefighters. The current chairman of the Spokane County EMS Council is Dr. Michael Metcalf, who just happens to be the medical director of the MSSP.
“What we’re trying to do is meld good care with what we have available on the mountain,” Metcalf said. “We need to make sure we operate without overstepping the standards of OEC care because of the liability of the Good Samaritan laws that cover our butts.”
In Washington State, the Good Samaritan Law protects volunteer providers of emergency medical care at the scene of an accident from liability for civil damages, with exceptions for “gross negligence or willful or wanton misconduct.” Because of their training, the threshold for negligence is low for ski patrollers and they must be careful.
Metcalf uses county protocols as a guide to write medical protocols for the MSSP. As a physician, his authority has allowed the MSSP to provide some potentially life-saving services beyond the standard scope of OEC training, such as blood glucose monitoring. The MSSP also has several patrollers who are qualified to start IVs and apply the King Airway, a device inserted down into the trachea of a patient who can’t breathe on his own.
Metcalf reviews certain rescues, or “codes,” where problems may arise that can be addressed with further training or an adjustment of the mountain’s medical protocols. He also educates patrollers about the considerable amount of paperwork that must be completed by the patroller who is first on the scene of a code.
“You need to have all the information reported, recorded, and able to transmit to the next level of care, which in our setting is often the AMR ambulance groups and paramedics,” he said. “It’s important for proper care, but it’s also important from a legal aspect. If it didn’t get recorded, it didn’t happen.”
Metcalf, who has been on the MSSP for 26 years, will be retiring from the practice of medicine in a couple of weeks. But he will continue to serve as chairman of the Spokane County EMS Council and as medical director of the MSSP. He’ll be at Mount Spokane every other weekend this winter, helping keep skiers and riders safe. But he downplayed his role.
“Any member of the patrol can manage just about everything,” Metcalf said. “They are trained to manage emergency care. A physician’s input is helpful and its reassuring to the group, but it isn’t necessary.”