Abstract
To the Editor:
The national medical committee of the National Ski Patrol (NSP) with representatives from all divisions throughout the United States read with interest the recent article by Fell et al. 1 While we applaud the effort and agree with some of the conclusions, we have some recommendations.
The conclusions state that the study demonstrated “variety in the training, medical care and medical direction of US ski patrols.” The limitation of sample size (approximately 5%) and selection bias toward western patrols is noted, but there is really no measure of medical care in the study. Measuring variety in medical care would require a comparison of actual protocols or chart reviews at respective ski areas, but this is listed in the title. The reader will benefit when the title, listed primary goals, and conclusions related to those goals are consistent.
The article infers that there is no national standard for the medical care at various ski resorts. The vast majority of ski patrols require either outdoor emergency care (OEC) or emergency medical technician training, and many require both. The training and testing, although different for both certificates, are standardized nationally, with both exhaustively peer reviewed by the certifying agencies. OEC meets and exceeds all requirements of the National Standard Curriculum of an Emergency Medical Responder developed by the US Department of Transportation, National Highway Traffic Safety Administration, and US Department of Health and Human Services. The local ski area ownermanagement together with the patrol members and medical advisor develop their own protocols to fit the needs of their particular area. Nationally, emergency medical services (EMS) does the same with each state creating legislation, and then the local EMS agency ownermanager along with their respective medical director develop their own protocols. Many states have standard protocols that they offer to local EMS agencies as a template, but the local agency still develops their own protocols. The NSP strongly encourages every patrol to have a medical advisor and to develop working relationships with local, regional, and state agencies.
I would recommend contacting the NSP or the National Ski Areas Association if you include them in an article for their perspective and insight into an issue. The NSP is a 30,000+ member organization with more than 600 registered ski patrols. The mission of the NSP is service and safety to the snow and bike communities we serve, the individual patrollers, and area employees. The Wilderness Medical Society and NSP share many common goals and members. The national medical committee of the NSP is committed to improving the delivery of medical care for all member patrols. Some patrols have the luxury of physician, nurse, paramedic, and EMT patrollers. Many do not and likely would not have the financial resources to implement such a program. The NSP medical committee is currently evaluating results from a survey with more than 300 patrol responses to evaluate the educational opportunities available in medical direction. There may be opportunity for a collaborative effort between our 2 groups in the future.
I appreciate the journal publishing this letter to the editor in order to provide a balanced and comprehensive analysis for the delivery of medical care for all guests, patrols, and resorts throughout the United States.