Avalanche Safety Practices Among Backcountry Skiers and Snowboarders in Jackson Hole in 2016.

INTRODUCTION: Carrying standard safety gear (beacon, probe, and shovel), planning a route of descent, and recreating with companions can help to mitigate the risk of injury or death resulting from avalanches in the backcountry. The goal of this study was to identify factors associated with performance of these safety practices. METHODS: A convenience sample of backcountry skiers and snowboarders was surveyed in 2016 at the backcountry gates of Jackson Hole Mountain Resort. Each participant was surveyed on characteristics including skill level, sex, age, prior avalanche education, and residency in the Jackson Hole area. Safety practices were also measured against avalanche hazard forecasts. Correlations were assessed using Fisher's exact testing. RESULTS: A total of 334 participants were surveyed. Factors associated with carrying avalanche safety gear included higher expertise, being a resident of the Jackson Hole area, and prior avalanche education. Factors associated with having a planned route of descent included higher expertise and being a resident of the Jackson Hole area. Factors associated with recreating with companions included younger age and lower expertise. Sex had no association with any of the surveyed safety practices. Participants were less likely to carry avalanche safety gear on low avalanche hazard days. CONCLUSIONS: Certain individual characteristics of backcountry skiers and snowboarders are associated with increased frequency of adherence to recommended safety practices. These findings suggest that particular categories of backcountry recreationists may benefit from further avalanche safety education. The results of this study could help direct future educational efforts among backcountry recreationists.

Diabetes-Related Knowledge of Polish National Mountain Leaders.

Nabrdalik, Katarzyna, Hanna Kwiendacz, Monika Gubala, Kinga Tyrala, Mariusz Seweryn, Andrzej Tomasik, Tomasz Sawczyn, Michal Kukla, Wladyslaw Grzeszczak, and Janusz Gumprecht. Diabetes-related knowledge of Polish national mountain leaders. High Alt Med Biol. 19:237-243, 2018.-Mountain trekking is a popular activity for patients with diabetes. In Poland, mountain leaders often accompany organized groups to ensure their safety during treks; we aimed to evaluate their competency in caring for diabetic clients by assessing their diabetes-related knowledge. This was a cross-sectional study among Polish, certified, active mountain leaders carried out by means of an anonymous, standardized 41-item questionnaire adapted from a study by Wee et al. It was distributed through e-mail to 500 leaders. A total of 106 (21.2%) mountain leaders completed the questionnaire (males 60.4%) with a mean (standard deviation [SD]) age of 38.6 (13.5) years. Their mean (SD) length of experience acting as a mountain leader was 11.9 (10.2) years. The average score was 72.4% of the maximum possible (29.7 of 41 points). Results varied significantly depending on gender (p = 0.006). The percentage of correct answers among questions in each section varied between 23.6% and 100%. The main sources of diabetes-related knowledge identified by respondents were members of their family and their friends who suffer from diabetes (33%). First aid courses were indicated as sources of information by only 12.6% of the informants. Results of the questionnaire revealed that respondents did have a reasonable level of diabetes-related knowledge. There were topics in which the respondents achieved lower than an average score, demonstrating a need for further education.

Safety in alpine helicopter rescue operations--minimal requirements of alpine skills for rescue personnel.

OBJECTIVE: There is a lack of data to establish minimal requirements for technical alpine climbing skills needed by rescue teams involved in alpine helicopter rescue operations to perform such operations safely. METHODS: A year of rescue operations (N = 2731) were investigated for the technical difficulties of the terrain. The difficulties were graded according to the Union Internationale des Associations d'Alpinisme (UIAA) scale for rocky terrain and steepness for ice slopes. RESULTS: For 99.7% of the operations, the terrain could be accurately evaluated. In at least 30.7% of all rescue operations, personal advanced alpine climbing skills were required for the rescue personnel, and in 6.0%, the difficulties of the rocky terrain correspond to UIAA scale grade III with another 2.4% to UIAA grade IV or above. About 1.5% of all operations took place in ice faces steeper than 50°. CONCLUSIONS: To be able to manage 90% of all operations safely, all crew members, except the pilot, must be competent at climbing rock terrain of UIAA scale grade IV and ice of 50° steepness using appropriate rescue, rope, and belaying techniques. These recommendations include a technical safety margin for adverse conditions, such as bad weather.

Preparation and medical outcomes of Nepalese staff and porters compared with foreign nationals on the Annapurna trekking circuit.

This cross-sectional study investigates preparedness and medical problems in Nepalese staff and porters compared with foreign nationals trekking at altitude in the Nepal Himalaya. 331 Nepalese and 338 foreign nationals in 61 trekking groups were surveyed over 4 weeks on the Annapurna trekking circuit. Foreign nationals reported that 92% of trekking groups received altitude illness information and carried a medical kit. However, fewer than 30% knew the evacuation insurance status of the Nepalese staff and porters on their trek, 39% would not pay for an ill Nepalese national's helicopter evacuation, and 41% reported insufficient resources to carry an individual. Medical problems occurred in 44% of groups. A significantly higher proportion of Nepalese staff and porters were evacuated compared with foreign nationals. No significant differences in Nepalese and foreign national preparation were found between groups with and without medical problems. Medical problems were commonly encountered, yet many groups lacked resources to evacuate someone dangerously ill. Foreign and Nepalese nationals have a duty of care towards each other; recognizing that preparedness relies not only on a first aid kit, but also on knowledge of acclimatization and individuals' insurance is an important part of health and safety for individuals trekking at altitude.

Risk assessment in winter backcountry travel.

OBJECTIVE: Risk assessment is an important part of safe backcountry travel in avalanche terrain. The purpose of this study was to determine and compare the ability of backcountry travelers to accurately estimate the avalanche danger for their destination and time of travel. METHODS: We surveyed 353 winter backcountry users, asking them to rate the avalanche danger for their destination that day. We then compared this estimation to the Utah Avalanche Center daily advisory for that specific location, aspect, and elevation. Tendency to underestimate the avalanche danger was then compared across 6 different sports (backcountry skiing, backcountry snowboarding, snowshoeing, snowmobiling, out-of-bounds skiing, and out-of-bounds snowboarding) as well as across age, gender, and subject participation in an avalanche safety course. RESULTS: A comparison across different sports, adjusted for age and gender, showed that snowshoers were 7.11 times more likely than skiers to underestimate the avalanche danger (95% CI, 2.95, 17.11). This difference was maintained after adjusting for past education in an avalanche safety course (odds ratio, 5.74; 95% CI, 2.28, 14.46). Snowmobilers were also significantly more likely to underestimate the avalanche danger when compared to skiers (odds ratio, 3.11; 95% CI, 1.12, 8.24), but these differences ceased to be significant when the data were adjusted for avalanche safety course (odds ratio, 2.39; 95% CI, 0.84, 6.74). While there was a trend for women and older age groups to underestimate the avalanche danger when compared to men, these trends were not significant. CONCLUSIONS: Snowshoers and snowmobilers are groups that tend to underestimate avalanche danger when traveling in the backcountry. These groups may be unknowingly assuming a higher risk and should be targeted for avalanche education and awareness.

Mountaineering expedition by persons with intellectual disability: impact on behavior and temperament.

The recreational needs of adults with intellectual disability are the same as those of the general population. If properly planned, recreational activities can facilitate positive behavioral changes. In this context, this present study was designed to understand the effects of a mountaineering expedition on the behaviors and temperament in a group of people with intellectual disability. The study included eight men and two women with intellectual disability aged 17-38 years. After a training programme, the participants went on an 11 day expedition in the Himalayan region under the supervision of professionals and two parents. Results indicated that all of them successfully climbed mountains up to 12,000 feet, and also had specific positive behavioral changes. Details and implications are discussed in this article.

Avalanche safety practices in Utah.

OBJECTIVE: Avalanche fatalities occur on a yearly basis in Utah. The purpose of this study was to assess avalanche safety practices of different backcountry users in Utah and to identify groups that can be targeted for avalanche safety education. METHODS: We surveyed 353 winter backcountry users to determine the percentage of participants in each group who were traveling with one or more partners; the percentage who were carrying avalanche transceivers, shovels, probes, or AvaLungs; and the percentage who had taken an avalanche safety course. A measure of minimum safe practice was defined as 1) traveling with a partner, 2) carrying an avalanche transceiver, and 3) carrying a shovel. Participants in this study were backcountry skiers, snowboarders, snowshoers, snowmobilers, and out-of-bounds resort skiers/snowboarders traveling in the Wasatch and Uinta Mountains of Utah during the winter of 2005-06. RESULTS: The percentage of backcountry recreationists traveling with one or more partners was not significantly different (P=.0658) among backcountry skiers, snowboarders, snowshoers, snowmobilers, and out-of-bounds resort skiers/snowboarders. These groups did, however, differ in the percentage who carried avalanche transceivers (P<.0001), shovels (P<.0001), probes (P<.0001), and AvaLungs (P=.0020), as well as in the percentage who had taken an avalanche safety course (P<.0001) and the percentage who were carrying out minimum safe practices (P<.0001). Backcountry skiers showed the highest level of avalanche preparedness, with 98% carrying avalanche transceivers, 98% carrying shovels, 77% carrying probes, 86% having taken an avalanche safety course, and 88% carrying out minimum safe practices. Out of bounds snowboarders were the least prepared with 9% carrying avalanche transceivers, 9% carrying shovels, 7% carrying probes, 33% having taken an avalanche safety course, and 2% carrying out minimum safe practices. CONCLUSIONS: There are significant differences in the avalanche safety practices of the various groups of backcountry travelers in Utah. Backcountry skiers and snowboarders were the most prepared, while snowmobilers, snowshoers, and out-of-bounds skiers/snowboarders were relatively less prepared.

Training for medical support of mountain operations.

Man is not designed to live or to fight at altitude, and mountains have successfully resisted armies' attempts to conquer them for centuries. High-altitude mountainous terrain imposes great strains on individuals, units, and the health services designed to protect them. Medical personnel are challenged to minimize the damaging effects of the harsh environment, to maximize survival rates, and to preserve combat effectiveness by optimizing physiological and behavioral adaptation. Such challenges are best met with targeted medical training. This article reviews basic altitude physiology, relevant military history, the scope of altitude illnesses, prevention and treatment strategies, and existing mountain medicine training programs.