Mountain Rescue Doctor

Packing for Haiti

2011-05-21T08:09:00.000-07:00

I'm leaving in a couple days for Haiti with Medical Student Missions to help teach a Wilderness First Responder course and work in a cholera clinic. Along with a small wad of clothes, running shoes, and Blundstones, here's the essentials crammed in a Patagonia MLC wheeled backpack.

Ben's DEET mosquito juice: combined with permethrin-treated clothing, this is nearly 100% mosquito-protective.

Ex-Officio bug-retarding, sun-protective shirt and Patagonia GI Pants, both sprayed with Ben's permethrin mosquito repellent.

Alcohol hand sanitizer.

Potable Aqua chlorine dioxide water purification tablets.

Sawyer SP140 water bottle with 0.1 micron filter.

Rx: Chloroquine antimalarial, azithromycine and ciprofloxacin antibiotics, loperamide.

Petzl Tikka headlamp.

Docs: Passport, emergency credit card, SOS International evac insurance, emergency contact list.

Sunscreen, sun hat.

Cocoon silk seeping bag liner, also nuked with permethrin.

Telecommunications: Dell Mini 10, iPhone, Panasoinc Lumix camera.

Stethoscope, nitrile gloves, scrubs

From my Outside Blog

Wilderness Medicine Courses Demystified

2011-05-11T09:04:00.000-07:00

From My Outside Blog

Summer adventure is nigh so arm your pack with a good first aid kit like one from Adventure Medical Kits. And learn how to use it. Here's the scoop on wilderness medicine courses.

CPR is a vital 3-4 hour class, endorsed by American Red Cross or American Heart Association.

Wilderness First Aid is a one- or two-day course that teaches basics of wound care and splinting. If you have time, find a more-detailed, three- or four-day Advanced Wilderness First Aid.

Wilderness First Responder, aka "woofer," is a 70-hour essential for guides, rangers, rescuers and travelers on expeditions to remote lands.

Wilderness Emergency Medicine Technician, or W-EMT, clocks in at 180-hours, and prepared one for a professional career in firefighting, ambulance response, and backcountry rescue.

Docs, nurses and paramedics can take a weekend-long Advanced Wilderness Life Support (sometimes called Wilderness Advanced Life Support); and they can get continuning medical education from a number of medical conferences.

For details, check Wilderness Medicine Institute, Wilderness Medicine Associates, Wilderness and Travel Medicine, Remote Medical International, Wilderness Medicine Outfitters and many others

Cycling, Portland style

2011-04-18T09:23:00.000-07:00

For the fifth year, hundreds turned out for one of the steepest road rides in the nation: Ronde PDX, officially known as De Ronde Van West Portlandia. The route: 47 miles, 7,700 vertical feet ascent, 26% max grade (twice). No prize but honor, no fee but massive calories, no support but what comes from your bibs, no sanction, no sponsors. Only the lion of Flanders mark the route. Yes, Portland has perhaps the largest cyclocross series in the world and yes, it's one of the most bike friendly cities in the nation. But the toughest hill climb too? Anyone got anything steeper?

From my Outside blog

Avalanche survial using airbag backpack

2011-04-16T20:40:00.000-07:00

Avalanche survial using airbag backpack

Big Avalanche on Hood

2011-03-11T13:56:00.000-08:00

If you've ever grumbled about chairlifts delayed spinning for storm recovery, or sidecountry gates being closed, or even inbounds uphill traffic curtailed, know it's all about safety. A big inbounds avalanche slid yesterday at Mount Hood Meadows, starting probably from 10,000 feet on the Wy'East Face (Newton Clark Headwall) and extending below the Heather Canyon Chairlift load station, at 5,000 feet. It likely slid on the Martin Luther King Day ice, the solidified 6 inches of rain that fell during a 24 hours stretch in January. Check out the 40-foot-deep debris at the chairlift here or an overview of the slide path from a January 2010 avalanche here. Now a good time to be thanking lift operations and ski patrol that no one was hurt.

From my blog on Outside. Be safe.

Top 5 Wilderness Medicine & Safety Trends

2011-03-05T07:54:00.000-08:00

Check out my story on the five trends to watch for 2011.
the list:
Wilderness First Responder course may standardize.
FEMA regulations are trickling down to podunk, impacting search and rescue volunteers.
Sidecountry and Inbounds Uphill Traffic in ski resorts is all the rage, but access may be limited.
Need to be rescued? Carry your credit card
Electronics galore: a constant change.

Top 5 Wilderness Medicine & Safety Trends

Your Skimo Valentine

2011-02-09T09:53:00.000-08:00

Need a last minute gift for your ski mountaineer Valentine? Chris Davenport and his skimo cronies produced a pair of tomes as big, bold and beautiful as the mountains themselves.

Ski the 14ers chronicles Davenport’s year long odyssey to conquer the majestic peaks of Colorado; a feat which logged 200,000 vert. Fifty Classic Ski Descents of North America, coauthored by Penn Newhard and Art Burrows, is reminiscent of Steve Roper and Allen Steck’s 1979 epic Fifty Classic Climbs of North America. Spanning the Messner Couloir on Mount McKinley to Tuckerman Ravine on Mount Washington, you’ll find a dearth of actual route information. But the point is the stunning jaw-dropping images accompanied by brief anecdotes from Alpine legends like Lou Dawson and Andrew McLean. Notably absent was a ski descent or two in Mexico.

Be advised: neither volume will find a place on your Valentine’s bookshelf, but will become a permanent fixture on the kitchen table. Just have a Kleenex handy to wipe up the drool. Available through www.wolverinepublishing.com.

From my Outside blog

Clothes to Survive

2011-02-06T08:00:00.000-08:00

Our sheriff once told me stranded climbers survive longer on Mount Hood nowadays. The reason: clothing rocks. So, whether you’re out for a half-day snowshoe junket or on peak-bagging ski mountaineering tour, here’s four wardrobe essentials that could save your life.

SAR on Hood: no country for a soft shell

Down Jacket. Unless it’s pouring rain, down is the ultimate lightweight layer for cold-weather survival. Choose your weapon based on climate like the fastpacking Cloudveil Endless Down for fair weather, the stylish midweight Patagonia Fitzroy for hut tours, and the burly Mountain Hardware Sub Zero XL for going deeper.

Gauntlet Gloves. If your hands get even slightly cold, simple tasks like clearing snow from a clogged ski binder become dangerous. Mittens are warmer but the dexterity of gloves rule for essential tasks like ripping skins or rappelling. I love the burly Gore-tex-clad, leather-palmed Outdoor Research Remote and Arc’teryx Alpha SV gloves.

Headgear. I work on Mount Hood, where storms come in all flavors: Pineapple Express rain, blistering wind and rime, and heavy snow. Cover all exposed skin to prevent frostbite. I like the washable ultrathin Smartwool neck gaiter because I can tuck it under my goggles and helmet, (which you’re wearing too, right?).

Hardshell. Soft shell are versatile and comfy, but for search and rescue callouts, ski resort doc duty, and storym sidecountry junkets, I always have a hardshell. The Helly Hansen Odin Mountain Jacket is lightweight, rime-proof, and the hood actually fits over my helmet (did I already mention wearing a helmet?). Pants come in all styles and fits nowadays, but you can’t beat timeless, old-school simplicity of The North Face Guide Pant.

Doc's lab (L to R): Ski Trab, Life Link, The North Face, Outdoor Research, Arc'teryx, Patagonia, Mountain Hard Wear, Helly Hansen.

snow immersion deaths

2011-01-31T12:24:00.000-08:00

My blog on adventuremedicalkits.com, which makes superior first aid kits for work and play. amk blog

tree well suffocations continue

2011-01-11T09:21:00.001-08:00

The Missoulian reported what is probably the sixth death from deep snow and tree wells in a matter of a fortnight. Invesitgations in California, Montana, and British Columiba are still in progress on these non-avalanche, non-trauma deaths (one may be drowning and the other trauma). See my past blog for the scoop. Be safe.

tree well immersion

2011-01-03T10:06:00.001-08:00

Last week, massive storms pummeled the mountains with snow. Unfortunately, in a 48-hour span, three more cases of tree well accidents were reported. On December 28, a snowboarder went out of bounds from a Tahoe resort and was found in a tree well two days later. On December 29, a snowboarder on a guided backcountry tour in Canada died. Also last wednesday, an inbounds skier at a Montana resort was found in critical condition in a tree well. For the beta on safety, read my post from December 21 or this journal paper.

inbounds uphill traffic

2010-12-28T05:23:00.000-08:00

Along with the bourgeoning sport of alpine touring, many skiers and snowboarders are skinning and snowshoeing inbounds these days, requiring mountain resorts to figure out how to deal with uphill traffic. Although you may hear grumbling on both sides, know that resorts need to direct hikers safely away from avalanche control work, snowcat grooming operations, and scores of downhillers.

Whitefish Mountain Resort in Montana has an excellent solution I came upon when out on a pre-dawn climb yesterday: a designated, clearly-marked, uphill traffic route complete with an explanation of the policy in the base area.

My home peak, Mount Hood Meadows, directs skinners and snowshoers to two out of bounds routes and also posts avalanche control advisory information on the internet for a popular backcountry access route. Some resorts put the kibosh on inbounds skinning altogether for safety.

Why go up inside the ropelines? To test new gear in the relative safety of the resort, get some exercise, access the sidecountry, or simply try something new.

If in doubt of the uphill traffic policy, check in with ski patrol.

Tree Well Deep Snow Safety

2010-12-21T08:58:00.000-08:00

As the west gets pounded by storms in what has been a best winter season opening in years, hopefully everyone has been out powder farming the light, dry, deep crystalline snow. When tracking up my local backcountry stash this weekend, I spied giant tree wells, big as black holes. Be careful of this lesser known mountain hazard: fall in a tree well or deep snow, and you can suffocate. Called Non-Avalanche Snow Immersion Death, or NARSID, it is better described Snow Immersion Suffocation.

The key is avoidance and quick partner rescue if you fall into a tree well. To avoid: ski and ride within your skills, use the proper tool (big pow mean big sticks), and employing a buddy system—stay in voice and visual contact, which you should be doing anyway. If you get sucked in: try to tuck, roll, and land upright, grab the tree trunk or a branch, and yell to alert your partner. If buried upside down, stay calm and create an air pocket, which is probably of paramount importance. Avalanche safety gear may speed rescue if your location is unknown. But know that you can suffocate as quickly as you can drown in water.

For more info, check out the comprehensive journal paper published recently in Wilderness and Environmental Medicine or the website treewelldeepsnowsafety.com.

Be safe.

--Christopher Van Tilburg, MD

From my Outside Magazine blog: http://outside-blog.away.com/blog/christopher_van_tilburg.html

Bicycle Weight and Commute Time

2010-12-14T14:47:00.000-08:00

Deep down, most of us know it's the riders legs not the bike. When British Doc Jeremy Groves upgraded his $50, 30-pound steel commuter clunker to a $1560, 21-pound carbon beauty, he didn't feel like he was riding that much faster. So, he set off on a test. Just published in British Medical Journal this week, he completed a randomized trial. He alternated the two steeds on 26 commutes covering 711 miles. The result: he was equally fast on both bikes. Considering gravity, friction aka rolling resistance, and drag, the 30% reduction in bike weight--which translated to 4% bike+rider weight--made nary a difference in commute time. Incidently, the author preferred the character and comfort of the steel commuter, in addition to its value. Dr. Grove's conclusion: bike commuters may look at weight reduction of the cyclist, rather than the bike, to improve preformance at a much reduced cost.

--Christopher Van Tilburg, MD
http://outside-blog.away.com/blog/christopher_van_tilburg.html

Medical Kits for weight weenies

2010-11-10T13:33:00.000-08:00

Minimalist medical kit

Here's the latest post from my Outside blog.
I’m a minimalist—even when it comes to carrying a medical kit. On big weekend tours, you should take a full medical kit like one by Adventure Medical Kits. But do you need to take the full shebang every time you step out for a two-hour mountain bike ride on your local trail or a quick sidecountry jaunt at the ski hill? Here the five essentials.

1. Tape. You can improvise splints and bandages from ski poles, clothing, and the stays of your backpack, but you can’t improvise tape. My favorite is Johnson & Johnson waterproof first aid tape: sticky, hypoallergenic, and slick for blister prevention.

2. Compression wrap. Two common afflictions to backcountry travelers are sprains and wounds like cuts and scrapes. The best all-purpose dressing is Coban self-adherent, reusable wrap.

3. Communication device. The best combo is a GPS and cell phone, or a personal locator beacon. Tell us SAR guys a) you need help and b) where we can find you.

4. Pain medication. Carry ibuprofen and acetaminophen or prescription-strength prescribed by your doc.

5. CPR mask and nitrile gloves. Protect yourself first, hopefully you never need these.

--Christopher Van Tilburg, MD

Wilderness Medical Society Travel, Dive and Marine Medicine

2010-11-02T22:11:00.000-07:00

Top rate speakers on the Kona Ironman, ocean lifeguards, surfing injuries, and dive accidents. Plus a few excursions into the Maui backcountry/upcountry.

Trail to Honoloa Bay

Local Beta

Waihee Ridge Trail

West Maui Mountains

Honoloa Bay at double overhead (no, I didn't go out)

Powder day on Mount Hood in October

2010-10-27T14:53:00.000-07:00

Cold, clear, dry and deep.

Uphill: thanks to SkiTrab, Garmont, Dynafit, and Lifelink

Downhill secret weapons: Swix U-10 and ginger cookies

gifford pinchot search, washington, 10/20/10

2010-10-20T16:14:00.000-07:00

How to Save a Life

2010-10-19T09:28:00.000-07:00

Back in 1960, doctors wrote about the first 14 lives saved with chest compressions. Now, fifty years later, new CPR guidelines published yesterday by the American Heart Association (AHA) reinforce the importance of this life-saving technique.

For lay, untrained bystanders, AHA gave the go-ahead two years ago for "Hands Only CPR." Your instructions: push hard and fast at the center of the chest. Don't take direction from ER or House. Keep pace with the Bee Gees Staying Alive and compress the chest two inches. Need a reminder: AHA has a youtube video and smart phone app.

For anyone with formal CPR training, the new guidelines emphasize chest compressions over respiration. Instead of airway-breathing-circulation, the long-term ABC mnemonic, it's now C-A-B.

And, if you can find an Automated External Defibrillator, omnipresent in airports, sports clubs, and ski patrol shacks, use it. They are simple and require no training.

For the science wonks, check out the full report in Circulation.

--Christopher Van Tilburg, MD

The Golden Rules for Alitude Illness

2010-10-07T08:41:00.000-07:00

A new study published in High Altitude Medicine and Biology cautioned us against standard tactics to ward off altitude illness. The review of Kilimanjaro climbers showed that neither a single rest day nor drugs (acetazolamide) helped prevent acute mountain sickness. Although aclimatization beforehand helped. In short, raising awarness is important. It reminds us of the golden rules proposed by mountain docs David Schlimn and Tom Dietz posted at the International Society for Mountain Medicine:

GOLDEN RULE I

If you feel unwell at altitude it is altitude illness until proven otherwise.

GOLDEN RULE II

Never ascend with symptoms of AMS.

GOLDEN RULE III

If you are getting worse (or have HACE or HAPE), go down at once.

Ibuprofen for high altitude headache

2010-09-30T07:01:00.000-07:00

Prescription-only acetazolamide has long been standard prevention for acute mountain sickness. A new study just published in Wilderness & Environmental Medicine suggests ibuprofen works equally well to stave off the most common malady: the dreaded high altitude headache. The randomized, double-blind trial was completed in the Nepal Himalaya under the auspices of Himalayan Rescue Association. Test dose: 600 mg starting the day before ascent.

Lawmakers try to mandate cell phones--again

2010-09-21T08:59:00.000-07:00

After the grueling two-week Mount Hood search in 2006, Oregon lawmakers tried unsuccessfully to require cell phones for climbers. Replay: after a brutal 2009 search on the same peak, above, Washington introduced a similar bill, according to an extensive story in Northwest Mountaineering Journal (NMJ)

Although telecommunication devices are useful to rescuers, they don't always work: batteries fail, signals drop, the oft-complicated technology begets errors. In addition, the electromagnetic cloud from the plethora of devices--avalanche beacon, GPS, cell phone, UHF/VHF radio and personal locator beacon--has been reported to cause frequency interference.

The down side: mandating cell phones possibly means mandating rescues, opening up potential for lawsuits. And the story in NMJ provides good evidence that adventurers will take more risks. Nevermind that most SAR calls are not even for mountaineers: hunters, boaters, hikers and motorists top the list.

--Christopher Van Tilburg, MD

No Charge for Rescue Heats up

2010-09-13T19:53:00.001-07:00

After the Colorado Search and Rescue Board (CSARB) successfully help convince one mountain town to stop charging for rescues, municipal public safety agencies seem to be sending more bills. According to the New York Times last week, if you need help from police or fire, don't be surprised to get a bill, the so-called "crash tax."

Eight states can lawfully bill for search and rescue services. Remember the teenager in New Hampshire's White Mountains who was sent a $25,000 tab? The Mountain Rescue Association and National Association for Search and Rescue are adamantly against cost recovery in this manner. The reason: it promotes a delay in a call for help.

The CSARB recently posted first-hand accounts of those who put the kaibash on callling 911 for fear of getting dinged for cash. Of the success, CSARB Public Affairs Manager Howard Paul said, "We got Golden, Colorado, to change municipal code to stop charging for rescue. Citizens and businesses involved in recreation took the lead, because the policy hurt toursim in outdoor recreation."

Follow the simmering controversiy on Facebook's No Charge for Rescue, 2,700 fans strong.

Mountain Running

2010-08-09T20:47:00.000-07:00

Mountain Running, Whitefish Range (photo Skylar VT)

We've been a little slow in the mountain rescue department in Hood River County, Oregon, which generally is a good thing. We were called out for the Kyron Horman search in Portland. And we had a few "stand by" calls for the south side of Mount Hood this month to assist our colleagues from Portland Mountain Rescue.

Cooling off, mountain style.

Going down hard on talus.

In the meantime, we're staying in shape. Here are a few picks of mountain running in and near Glacier National Park.

Left the car in clear blue sky, sun, at 60-degrees enroute to Hidden Lake. On the way back: wind, rain, and temp dropped 10-degrees--mountain weather, expect anything..

Mountain goat and bighorn sheep had their fill of wildflowers.

Watum Lake

2010-07-18T17:21:00.000-07:00

Summit of Chinidere Mountian above Watum Lake

Hood River County

July 2010

Took the girls and friends up to Watum Lake. It'd been on my list for a while. Watum Lake is a fairly remote area of Hood River County, and I wanted to get to know the surrounds better. We get a couple calls a year from Watum. Sometimes snowshoers/snowmobilers in the winter. Often hikers or equestrians in summer. The girls, friends, and I hiked in late last friday, pitched camp on the shores, and jumped in the glacial-fed, ice-cold lake. On saturday, we cruised south on the Pacific Crest Trail to the headwaters of Eagle Creek...yes another place we get lots of SAR callouts. On sunday, we hiked Chinidere Mountain and had spectacular views of Hood, Adams, Rainier, and St. Helens. And, admist the talus of Chinidere's summit, we found some ancient vision quest pits. Sure enough, this morning at midnight, we got a page for a Watum Lake standby--a hiker with a knee injury. We were to be on standby at Watum Lake at 7 a.m. I was up at 5 am ready to roll but we were called off when the party made it out on their own.

Three Days in the Green Desert: Palouse Hills and Elkhorn Mountains

2010-07-06T09:56:00.000-07:00

When my friend wanted to head out the Palouse, the ultra-rural wheat-growing hills of SE Washington, based solely on a one-paragraph clip in Sunset Magazine, I first crinkled my nose. Then, I decided it would be the perfect weekend to a) test my new cyclocross bike and b) scout out a few backcountry ski areas I’ve had my eye on for a couple years in hopes of adding them to the long-awaited revised edition of Backcountry Ski Oregon.

Palouse Falls State Park

More on how I accidently got into cyclocross later…and how I built the bike (I usually work on people, not bikes).

On short notice Friday, we loaded up bikes and skis, drove to Palouse Falls State Park, and camped under the setting sun. On Day 1, we scrambled around the falls under a sunny-blue sky. Then we biked 50 miles to Little Goose Dam, along the wild and scenic Snake River. Unlike the usual brown hills of the scablands, all the spring rain left a spectacular green hue to the hills and roadsides, with wildflowers just blooming and the grasses taller than me. The bike, with an aluminum frame and knobby tires was a little rough on the pavement but handled the gravel roads like a champ. After our ride, we drove south to Walla Walla, stopped in at L’Ecole No. 41 and Tertulia Wineries, and later—on a tip from the purveyor of the latter tasting room—camped at the summit of the Blue Mountains near Spout Springs Ski Area, where white tail deer grazed in a wildflower meadow at our camp.

Spout Springs Ski Area

Day 2, we headed to Anthony Lakes, in the heart of the Elkhorn Mountains. We circumnavigated the mountains in a 12-mile run/hike that took us around Lees and Angel Peaks, up to an old lookout with views spanning to the Wallowa Mountains, and back through Anthony Lakes Mountain Resort. There wasn’t quite enough snow to make turns, but the scenery was spectacular.

On Lookout Peak eyeing the ski routes on Lees and Angel Peaks; Anthony Lake w/Elkhorn Mountains is a mediocre view.

On Day 3, with blue skies, we decided on a whim to ride the 100-mile Elkhorn Scenic Byway loop through old gold mining towns, past dredges and tailings of a bygone gold-rush era, along the pristine Powder Creek, and into a vicious headwind in the farming community of Baker City valley. The ride culminated with the 3000-foot, 9-mile grind back to Anthony Lakes (elevation. 7190 ft). Other than a few minor adjustments, the bike is good to go for fall cyclocross and the Elkhorns are top priority for a backcountry trip this winter.

After the 100-miler.

The bike I built myself (well…with some help from my pals at Mountain View Cycles in Hood River, OR)

Redline Conquest Pro frameset with carbon fork.

Shimano Ultegra gruppo with compact crankset, 11-28 cassette, cantilever brakes, and 540 SPD pedals; the 6700 Ultegra series is amazingly smooth to shift and after 150-miles required no adjustments.

Ritchey bars, stem, and seatpost with Titec saddle; this aluminum kit is light, strong and tight.

Shimano Ultegra wheelset with Continental Cyclocross Race Tires; for years I've used ContiVapor Pros for my mountain bike and Conti Grand Prix 4000 for my road bike so it's no surprise this rubber is superb. The wheels do double duty and take a tubeless tire too!

Mount Shasta Ski

2010-06-28T10:23:00.000-07:00

Shasta and Shastitina

Two fellow Crag Rats and I drove down to Mount Shasta and skied the north slope last weekend. We drove to the North Gate Trailhead and took the Hotlum-Bolum Ridge. The first day, after a long drive, we hiked up to 10,000 feet can camped. We got rained and hailed on, and a fog moved in that evening.

High camp, in the evening fog and sunset.

The next morning the skies were crystal clear and temps in mid-40s F. Our total ascent was about 7,500 feet and we skiied about 6,500 feet.

Climbing Hotlum Glaicer in full frame boot crampons.

The ski out to the car, difficult route finding. lucky for map and GPS.

Gear I used: Ski Trab Free Rando AT skis with Dynafit Comfort binders, Black Diamond skins, Dynafit ski crampons, Stubi boot crampons, Stubi self-arrest grip poles, and Garmont Dynamit AT boots.

Coe Glacier Mission

2010-06-19T06:50:00.000-07:00

Here's a synopsis of the rescue turned recovery mission on the Coe Glacier this week. Foul weather pushed the Tuesday accident into Wednesday then Thrusday. http://www.kgw.com/news/Climber-dies-after-fall-on-Mt-Hood-96476044.html

The Minimalist Ready Pack

2010-06-16T06:16:00.001-07:00

One of my medical school professors told me once, rightfully so, I was a minimalist. When it comes to my SAR ready pack, I like the “light is right” mantra, which I call “weigh less, take less.” Here’s the bare minimum I carry in my summer SAR pack.

1. Backpack. I have a devoted “ready pack” specifically for SAR. I still use a rather hammered bright yellow DaKine Guide Pack (www.dakine.com). It’s half full, so I can toss in gear at the trailhead like technical rope rescue gear, a life jacket, or, more than once unfortunately, a body bag.

2. Personal protection: a Black Diamond helmet, clear-lens Smith goggles, hardware-store leather gloves, medical gloves and a compact CPR mask.

3. Navigation: Mount Hood Wilderness Geo-graphics map, Suunto compass, and Magellen Triton 2000 GPS. These tools along with communication, either a cell phone or radio, is of paramount importance for anyone staying found in the wilderness.

4. Electronics: I carry way too many, see my blog last month. I carry the GPS, UHF/VHF Yaesu VX-76 radio, Nikon Coolpix S620 camera, and battery-sucking iPhone.

5. Rope rescue: Black Diamond Alpine Bod harness, compact PMI escape rope (20 m x 7.5 mm), a 5 m length of one-inch webbing to sling a tree or improvise a patient harness, three locking ‘biners, three rope Purcell prussic for ascending, two Petzel Tibloc ascenders, a micro-eight descender, a Black diamond ATC descender, and a pully.

6. Survival stuff crammed in the bottom: North Face Mountain Light jacket, spare fleece hat and polypro gloves, a bottle of water, a few granola bars, Adventure Medical Kits bivy sack, small foam Cascade Designs Thermarest pad (to sit on or make a splint), and a small survival kit that fits in zip-lock freezer bag.

7. Advance life support kit: usually goes up the trail, but not always.

8. For canyon/water rescues, a Patagonia PFD and a Promotion neoprene shirt.

9. For summer rescues on the mountain: crampons, ice ax, and winter clothing.

The mountains don't know it's June

2010-06-08T14:01:00.001-07:00

Heavy rains in the PNW has brought a slew of weather to the Cascade volcanoes. A large avalanche on Mount Rainier Saturday took out 11 people. One climber was airlifted and another is still missing. The AP has a nice synopsis at http://www.cbsnews.com/stories/2010/06/06/national/main6553641.shtml and the Northwest Avalanche Center has a special statement on this June storm (www.nwac.us)

Basically, the Cascade Volcanoes don’t much pay attention to the human calendar: snow up high, wind loading the slopes, rain tossed in the mix, and now sun and warmer temperatures. Combine ingredients, mix them up, and you get instability in the snowpack. The result: the mountains are dangerous. So be careful!

Year round when climbing and skiing, I carry an Avalung Covert pack (www.avalung.com), a Barryvox Avalanche Beacon (www.mammut.ch), the Tour probe/shovel from Backcountry Access (www.backcountryaccess.com) and the ten essentials. But this stuff takes skill and experience to learn to use and if someone is pulling this gear out of their pack, it means their primary and secondary safety valves have blown.

My recommendation for mountaineers: take a weeken-long avalanche awareness course (commonly called Level I) and read one of the books available. My favorites are Snow Sense: A Guide to Evaluating Snow Avalanche Hazard by Jill A. Fredston and Doug Fesler and Avalanche Aware, 2nd: The Essential Guide to Avalanche Safety by John Moynier.

Regardless of education, skills and experience, we all have to be careful of mountain terrain, weather and snowpack conditions that can cause avalanches. The accident is sad. Let’s keep hoping the missing climber will turn out safe and that the injured will heal quickly.

What's in my Pack

2010-06-03T09:11:00.000-07:00

Years ago, I was teaching an avalanche course years ago and all of us instructors were asked to unload our packs. It felt like we were divulging secrets, our private stash of hand picked gear. Over the years, new technology has allowed us to refine our portable home: lighter, smaller, more durable. Here are my five favorites, with the disclaimer that I’m a full-on minimalist. You might want to carry a scosh more gear.

1. Backpack. I love no-frills packs, a trend that deviates from the over-accessorized, too-many-zippers haulers of the last decade. The Osprey Talon 44 is extremely light and adjustable (http://www.ospreypacks.com/). My second choice for multiday excursions is the Deuter Air Contact Zero, at 70-liters large (http://www.deuterusa.com/). The only issue with light packs, the buckles and fabric are not quite as durable, especially for the dreaded black hole of checked baggage or the superfun squeezes of slot canyoneering.

2. Tent: The Sierra Designs Antares 3 is compact to carry and simple to pitch; it held four of us on a three-day trip to SoCal’s Catalina Island. Check out this years version, the Meteor Light 3 (http://www.sierradesigns.com/).

3. Stove: The MSR Pocket Rocket is tiny, clocks in at 3 ounces, and boils a liter of water in tres minutos. For one-nighters, I carry the micro 4-ounce fuel canister (http://www.msr.com/).

4. Sleeping bag: I love the Marmot Fusion 15, which is half Primaloft, half down giving the best of both fill material (down for warmth and comfort, Primaloft for the soggy rain world of the PNW and river trips (www.marmot.com). For colder climes, I take the comfy, compressible, and toasty Mountain Hardware Phantom 15, with 800-fill-power down (http://www.mountainhardware.com/).

5. Sleeping Pad. Why is this so important? Because a good pad keeps you warm and helps you snooze after a long day in the mountains or on the river. For uberlight overnighters, I like the slim and trim Thermarest Guide Light ¾, now called ProLight (http://www.cascadedesigns.com/). But it’s not as nice the more bulky two-inch-thick Big Agnes (http://www.bigagnes.com/).

Pics: gear testing on South Sister, Oregon.

Next week: Search and Rescue Gear.

Teleelectrocommunicado

2010-05-26T14:50:00.000-07:00

Teleelectrocommunicado, n. superabundance of electromagnetic correspondence

NASA just announced the next generation of search and rescue software/satellites called the Distress Alerting Satellite System (DASS). More progress in the name of teleelectrocommunication. I’m a digital native. Had Pong, Commodore 64, Atari, green-screen Apple 2E, IBM PC with 5.25 inch floppy. I’m a firm proponent that electronics must enhance your life…for me that means more time for family, travel, trail runs, and rides on my fully mechanical new cyclocross steed. In mountain rescue, we’ve got a multitude of electronics to enhance our mission. Here’s what I carry.

Watch: decade-old, twice refurbished Suunto Vector, with an altimeter, barometer, and compass.

iPhone: check. I get good reception on Mount Hood but it sucks the batteries and reception dwindles with the charge.
GPS: Magellan Triton 2000.
Headlamp: halogen/LED bulb Petzl Duo.
Camera: compact Nikon Coolpix S620.
Avalanche beacon: Mammut Barryvox—if you’re not practiced you may be better off with a user-friendly Tracker DTS.

Radio: Yaesu VX-7R VHF/UHF, water-resistant and programmable.

I don’t carry a Personal Locator Beacon. They are widely available but still costly. They are similar to Emergency Position-Indicating Radio Locators used on ships and airplanes. I don’t carry a RECCO reflector (small chips usually sewn into ski or snowboard clothing) or the microwave transmitter/receiver (some ski resorts have these). Similarly, I carry neither a Mountain Locater Unit (unique to Mount Hood, it’s basically an animal tracker rigged for climbers) nor the receiver, but our sheriff has one. The pic above is the MLU.

Sometimes, this stuff doesn't work--cold, dead batteries, poor receptions, deep canyons, or a dropped pack can render them inoperable...or simply weather like this night above when you can't take your hand out of the glove. That reminds me: I need to go charge up the whole shebang. If only these devices had a common charger and battery gauge it would make life much simpler.

Mount Hood SAR Operations November 2009

2010-05-19T09:31:00.000-07:00

Many readers have asked me about the Mount Hood search operations last winter. In November 2009, our mountain rescue unit, Crag Rats was called to search for three missing climbers on Mount Hood. I woke at 5 a.m. and saw the text message from our callout coordinator Penny. I quickly grabbed my winter gear, brewed a press pot of Stumptown, scarfed some granola, and drove 40 miles to search base. At Wyeast Day Lodge at Timberline Lodge, I was paired with two colleagues from Portland Mountain Rescue.

We caught the 8 a.m. snowcat to the top of Palmer Chairlift. We were tasked with achieving the summit to search the top of the climber's route, the Leuthold Couloir. We climbed in blistering freezing rain, which turned to rime, then promptly encrusted us in ice, making our jackets and pants stiff. The wind was 10-15 mph and the sky was a thick, flat gray. It was like the inside of a ping pong ball, the sky and snow were toned the same flat light gray hue. This was no country for a soft shell: windy, cold, and wet. Luckily, I was testing a Helly Hansen Odin jacket, a light but weatherproof bright orange shell with a hood that fit over my helmet. I was feeling rather Pillsbury, with a Patagonia Capiline shirt, Regulator fleece sweater, Climb High down vest, and Solstice soft shell jacket layered thickly under the parka.

We climbed Triangle Moraine toward the summit, but turned back at 11,000 feet on Hogsback Ridge, due to increasing avalanche risk, high winds, limited visibility, and cold. My toes were icy from being crowbarred into new alpine touring boots which were not yet molded to my feet.

Around noon we were redeployed to Illumination Saddle, where several teams from American Medical Response's Reach and Treat Team and Portland Mountain Rescue (PMR) converged to recover the body of one climber. We set up the PMR “Hogsback Kit,” a simple, efficient rope raising/lowering system using two pickets buried as “deadman” anchors and one super-long 600-foot rope. After hauling the the climber’s body up to Illumination Saddle, we shlepped the litter back a snowcat waiting for us at 8,000 feet above Palmer Chairlift. One PMR member lead us back with a GPS since it was still stormy with flat light.

We caught a ride down at 4:30 pm and I made it home by 7:00 p.m. where I spread out my gear to dry and repacked my backpack. Sometime around 10 p.m. I Penny texted that the search was suspended the next day due to high avalanche dangers.

Mountain Rescue Doctor

2008-01-28T20:27:00.000-08:00

Welcome to my Mountain Rescue Doctor blog. Many of you read my book and sent in great emails regarding the stories. I'll try to answer the most popular questions. Feel free to shoot me a quick note at vantilburg@gorge.net.

It's cold and snowy in Hood River. Twice in the last weeks, we've been called out. I threw together my winter gear, and donned five layers of clothing only to be called off or turn around. I think getting all five layers of winter clothes off is more difficult than getting them all on. These days, I wear at least a layer or two of Primaloft, a down-substitute which is warm, light, compressible, and, washable! I'm still a big fan of Patagonia underlayers and merino wool socks! I test lots of outdoor gear and my latest cool find was merino wool/Primaloft blend socks by Fox River! Socks are very important!

Sometimes, the mundane tasks of moutain rescue take the most time. After helping Penny with a 5 a.m. call out a few weeks ago, I really got frustrated that our cell-phone text message system broke down. After an hour on the phone to ATT and a couple days agonizing over the failing system, I finally figured out that two member cell phones didn't make the conversion from Cingular to ATT with text message. As you tech heads know, with group emails, two returned text messages can shut down the whole system. I'm a firm believer that technology should make our lives easier, not more complicated; computers, web bill pay, text messaging, and such should give us more time for a run in the rain, dinner with family, or a few hours ripping turns at the mountain! So, problem solved: we are up and running with text message callout. It's not all drama and excitement!

Some FAQs about the book:

Yes, several chapters don't really say what happens to the patient. That's part of the deal with mountian rescue missions: we hand off the patients to a helicopter or ground ambulance crew and sometimes we never find out the end result.

Many of you, from med students to paramedics, have asked me about a career in wilderness medicine. The short answer is that until you get a few books under your belt, you probably need a day job! Those of us who make part of our living in wilderness medicine do so via consulting, writing, and lecturing. Unless you are in the military or an academic, it may be best to look at wilderness medicine as an adjunct to a career or a superfun hobbie. And you don't need to be a doctor to be an important force in this field. Just check out what my friend Paul Bauger, a ski patroller and avalanche expert, has done with deep snow submersion at http://www.treewelldeepsnowsafety.com/.

If you are intrested in more training in wilderness first aid or medicine, here's what I recommend. If you have no medical experience, take a American Red Cross CPR and first aid class. If you spend time in the backcountry, advanced wilderness first aid is an added bonus. If you work in any capacity in the outdoors--as guide, ski patroller, or park ranger--or if you spend weeks in the backcountry, I recommend either Wilderness First Responder (one week) or Wilderness EMT (one month). Both are excellent courses.

For more info on wilderness medicine, check out http://www.wms.org/ or attend a conference. I'll be faculty speaker this year at: Park City, UT, in February; Snowmass, CO, in July; and Maui, HI, in November, a dive and travel medicine conference I put together with my friend, surfing doc Andrew Nathanson.

Email with questions!

CVT, February 2008