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says. He’s also adamant that pa­trollers need to be think­ing about the big­ger pic­ture of med­i­cal care, es­pe­cially when trans­porta­tion time is long. “The level of care off the hill makes all the dif­fer­ence in treat­ment,” Kaplan says. “What’s down the road at the next de­ci­sion point im­pacts how you give care. It’s pretty stress­ful when you have some­one who is re­ally un­sta­ble and you’re wait­ing for the am­bu­lance to show up.”

Breck­en­ridge and Bear take dif­fer­ent ap­proaches be­cause there’s no in­dus­try stan­dard for ski-pa­trol med­i­cal care. Ski pa­trol is a part of the EMS sys­tem, but that can dif­fer county by county, and pa­trols de­pend on their in­di­vid­ual med­i­cal di­rec­tors to set the di­rec­tives. “We have to work un­der a doc­tor, and ours is re­ally great—he skis all the time. We’ve known him for 25 years. At a lot of other ar­eas, the docs have come and gone,” Breck’s Mortensen says. “We’re push­ing pretty hard to be at the fore­front of what we do, but a lot of it comes down to pol­i­tics.”

That fore­front in­volves sup­plies, treat­ment pro­to­cols, and get­ting pa­tients off the hill. Pa­trols ob­ses­sively check out what other re­sorts are do­ing to see if it might make sense for them. “Aspen High­lands, for in­stance, has a fairly ag­gres­sive pain-medicines pro­gram,” Mortensen says. “They’re adopt­ing strate­gies from the mil­i­tary field. In com­bat, the in­jured re­ceive ke­tamine [an anes­thetic], so now some ski ar­eas give ke­tamine. These are the con­ver­sa­tions we have and are hav­ing with our doc.”

What’s more, the fo­cus on crit­i­cal care re­flects changes that are hap­pen­ing in­dus­try-wide. “The old boys’ club of the ski in­dus­try, with their ‘This is how we’ve done it, this is how we’ve al­ways done it, suck it up and get in my to­bog­gan’ at­ti­tude, has gone by the way­side,” Mortensen says. “Now we can of­fer a ton of free ser­vices. We were Oba­macare way be­fore there was Oba­macare.” ●

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