title: A survey of emergency medical services in mountain areas of Europe and North America: official recommendations of the International Commission for Mountain Emergency Medicine (ICAR Medcom).
abstract: Survey of on-site treatment of patients in mountain areas of 14 countries in Europe and North America (nonresponder rate 33%) to compare emergency medical services. Around 37,535 ground rescuers and 747 helicopters are ready for evacuation of casualties and patients in mountain areas. And 1316 physicians and 50,967 paramedics take part in ground and air mountain rescue operations. In Europe, 63.2% of helicopters have a physician on board, 17.8% are staffed with a paramedic, and 19% have no medically trained personnel on board. In North America, 31.6% (p < 0.001) of helicopters are staffed with a doctor, 59.3% (p < 0.001) with a paramedic, and 9.1% (p < 0.001) have no medical personnel. The percentage of on-site treatment according to the recommendations of the International Liaison Committee on Resuscitation (ILCOR) or International Commission for Alpine Rescue (ICAR) varies among all countries (p < 0.001) and is positively related to the percentage of physician-staffed helicopters (r = 0.76, p < 0.001). Paramedics in 90.9% countries are obliged to be medically trained, but physicians only need to have a standardized training in emergency medicine in 50% (p < 0.042). On-site treatment according to ILCOR or ICAR recommendations is performed more often in countries where physicians are regularly involved in mountain rescue operations. However, no conclusions can be drawn from the data as to the efficiency of treatment. The data show a lack of medical education in specific, mountain rescue-related problems. Physicians involved should undergo suitable training.
authors.affiliation: Mountain Rescue Service provided by the South Tyrolean Alpine Association, International Commission for Mountain Emergency Medicine, Bruneck, Italy. brugger.med@pass.dmet.it
authors.forename: Hermann
authors.initials: H
authors.lastname: Brugger
authors.forename: Fidel
authors.initials: F
authors.lastname: Elsensohn
authors.forename: Dave
authors.initials: D
authors.lastname: Syme
authors.forename: Günther
authors.initials: G
authors.lastname: Sumann
authors.forename: Markus
authors.initials: M
authors.lastname: Falk
mesh_terms: D017732:Air Ambulances / Q000706:statistics & numerical data; D002170:Canada / Q000453:epidemiology; D004632:Emergency Medical Services / Q000458:organization & administration* / Q000706:statistics & numerical data*; D004634:Emergency Medical Technicians / Q000706:statistics & numerical data; D004635:Emergency Medicine / Q000458:organization & administration / Q000706:statistics & numerical data; D004869:Equipment Safety; D005060:Europe / Q000453:epidemiology; D006801:Humans; D007391:International Cooperation; D009051:Mountaineering / Q000293:injuries* / Q000706:statistics & numerical data*; D017063:Outcome Assessment, Health Care; D018635:Rescue Work / Q000458:organization & administration / Q000706:statistics & numerical data*; D012107:Research Design; D014481:United States / Q000453:epidemiology