Arapahoe Basin will no longer use volunteer patrol after 4 decades

[Carolinacub]

With all the talk about level of care administered I have to put my two cents in. On our patrol we have a fair number of higher level medical practitioner's, as a rule they hold their level of treatment to OEC certification levels. My understanding about the reasoning is to keep the Patrol indemnified as a whole. However...and we all know that there is always a however, they have told me that if the situation comes up that by holding yourself to just the OEC level care would endanger the patient then they are allowed to treat at a level that is consistent with their personal training. so for example a patient runs into a tree a crushes their windpipe and their only chance of survival is a on scene tracheotomy then they could perform that procedure without repercussion as long as they are certified to that level. I on the other hand could be held accountable if I tried the same thing since I don't have that level of training.

 

[Dwight]

Funny... at True North, the ski shop where I work as a boot fitter, we can't give a customer anything from our first aid supply, not even a bandaid. The reason in our Handbook is, administering any kind of first aid supplies to a guest can result in assuming liability for giving medical attention.

Like James said, we can sell Tylenol or Advil, but we can't give someone either of those items.

When I say Pro-Patroller, I'm really mean non-NSP. NSP-OEC protocol is no meds administered. Though I know there are paid/pro NSP patrolls too.

For instance the Patrol at Bachelor will administer "morhpine" if needed on the slopes.

Now in the Midwest, NSP Vol patrol is a service that we provide for the hill. Our small hill has about 250-300 incidents a season. Many school classes go to the hill and very high beginner ratio too. If EMT/Ambulance crew could get on a hill, we wouldn't need a patrol.

 

[Tricia]

I was curious if there was some sort of line between Paid Patrol and Volunteer Patrol.
I couldn't find much information on the difference on the NSP website but this Wikipedia listing is interesting.

From Wikipedia:
The nonprofit National Ski Patrol (NSP) is the largest winter education organization in the world. The NSP provides education, outreach, and credentialing related to outdoor recreation and safety. It is currently composed of more than 26,000 members who serve in over 600 patrols. NSP members, both volunteer and paid, ensure the safety of outdoor recreation enthusiasts in ski areas throughout the United States of America and certain military areas of Europe.[1] For its dedication to the promotion public safety in skiing and other winter sports, the group was granted a congressional charter under Title 36 of the United States Code in 1980.[2]

 

[Monique]

With all the talk about level of care administered I have to put my two cents in. On our patrol we have a fair number of higher level medical practitioner's, as a rule they hold their level of treatment to OEC certification levels. My understanding about the reasoning is to keep the Patrol indemnified as a whole. However...and we all know that there is always a however, they have told me that if the situation comes up that by holding yourself to just the OEC level care would endanger the patient then they are allowed to treat at a level that is consistent with their personal training. so for example a patient runs into a tree a crushes their windpipe and their only chance of survival is a on scene tracheotomy then they could perform that procedure without repercussion as long as they are certified to that level. I on the other hand could be held accountable if I tried the same thing since I don't have that level of training.

I would imagine that most health care practitioners, if it came to that, would rather be on the wrong side of the law/rules than see someone die when they could have prevented it.

Complete speculation on my part.

 

[pais alto]

I was curious if there was some sort of line between Paid Patrol and Volunteer Patrol.

I think it's more like a difference between EMT and OEC patrols, in the level of care they can provide. OEC is totally a NSP thing. EMT/EMS is regulated and licensed by states.

 

[Carolinacub]

I was curious if there was some sort of line between Paid Patrol and Volunteer Patrol.
I couldn't find much information on the difference on the NSP website but this Wikipedia listing is interesting.

From Wikipedia:
The nonprofit National Ski Patrol (NSP) is the largest winter education organization in the world. The NSP provides education, outreach, and credentialing related to outdoor recreation and safety. It is currently composed of more than 26,000 members who serve in over 600 patrols. NSP members, both volunteer and paid, ensure the safety of outdoor recreation enthusiasts in ski areas throughout the United States of America and certain military areas of Europe.[1] For its dedication to the promotion public safety in skiing and other winter sports, the group was granted a congressional charter under Title 36 of the United States Code in 1980.[2]

There is a line but it's thin, at least where I work.
On our mountain we have paid and volunteer patrollers. Both sets are NSP certified and that is the standard that our mountain holds all patrollers to. For our little mountain the paid patrollers work during the week as a full time job. Our volunteers cover weekends and most holidays on a volunteer basis. as far as level of care and duties there is no difference between the two. The only reason we have paid patrollers is so we can guarantee coverage during the week since almost all volunteers do this as a side note to their "real" jobs. Generally we are on great terms with each other.
I would say that this situation is more prevalent at smaller hills and at resorts that aren't owned by the big ski conglomerates. For the smaller hills the cost savings by using volunteers on weekends and such can be significant. on our little mountain we have approximately 40 volunteer patrollers. We expect them to do at least 100 hours a year. Lets say that labor is worth 10$ an hour, that's 40,000$ in labor that the mountain gets for free.

 

[DanoT]

Just to add to the thread drift: I am now retired but spent most of my working career as an Occupational First Aid Attendant in mining and logging remote areas in B.C. We were not allowed to stock our first aid rooms or industrial ambulances with meds of any kind (except Epi-pen and glucose). One of the reasons that we were given for this is that when as first-aiders, we turned a patient over to a higher medical authority (usually a hospital), they would do their own patient assessment and and didn't want meds blocking patient symptoms..

 

[Monique]

There are situations where these rules can really suck. A woman in my lesson group fell and dislocated her shoulder. She was a professional musician, so anything affecting her arms was a Really Big Deal. My understanding is that resetting it in the first minute is actually your best possible scenario, painful as it might be - but of course not allowed.

(I don't know if there's a possible downside to popping that arm back out/in)

 

[pais alto]

The reason shoulder dislocation reduction isn't allowed for patrollers is it's not in the scope of practice because there's a possibility of a fracture or tissue damage somewhere in the shoulder joint that should be examined and treated by a physician. That said, a number of people have had shoulder dislocations that can be reduced by the patient relaxing the shoulder muscles and exerting mild extension pressure on the arm, perhaps by lying prone on a bed or gurney and pulling softly down on the arm or putting some weight in the hand. Officially, this should be done by the patient themselves. If the patient has had more than one dislocation they might already be familiar with this procedure. If it's a first time dislocation, then the possibility of a fracture needs to be considered and checked by a physician.

In the long run an unreduced routine shoulder dislocation is more painful and anxiety-producing than presenting the possibility of permenant loss of function. So people need to be patient about it, it's not that Big a Deal compared to problems from an improper reduction.

 

[Carolinacub]

The reason shoulder dislocation reduction isn't allowed for patrollers is that there's a possibility of a fracture or tissue damage somewhere in the shoulder joint that should be examined and treated by a physician. That said, a number of people have had shoulder dislocations that can be reduced by the patient relaxing the shoulder muscles and exerting mild extension pressure on the arm, perhaps by lying prone on a bed or gurney and pulling softly down on the arm or putting some weight in the hand. Officially, this should be done by the patient themselves. If the patient has had more than one dislocation they might already be familiar with this procedure. If it's a first time dislocation, then the possibility of a fracture needs to be considered and checked by a physician.

I've actually been in some patrol rooms where they keep a 5lb dumbbell on hand. "apparently" the patient will attach the dumbbell to their hand with an ace bandage and then lie down with their arm dangling off the table.

 

[pais alto]

I've actually been in some patrol rooms where they keep a 5lb dumbbell on hand. "apparently" the patient will attach the dumbbell to their hand with an ace bandage and then lie down with their arm dangling off the table.

Yeah, who knows what a patient will do when you're not looking. Just like how sometimes they might find some ibuprofen lying around and take it.

 

[Monique]

I remember at the time the instructor, a guy I've known for years, was pretty stressed. Well, for a variety of reasons, but among them - he had "relocated" his shoulder countless times, but he knew he wasn't allowed to fix hers.

Anyway I'm sure actual patrollers have a million stories like this.

 

[gwasson]

From what I've read, the crackdown in opiate prescriptions has led to more people getting hooked on heroine. Kind of obvious once you think about it. And of course, street heroine isn't quite as likely as prescriptions to be "clean" ...

One of the leading things getting people hooked on heroin is actually the OVER prescription of opioids. People become dependent very quickly and when then can either no longer get a prescription, or afford a prescription, they turn to heroin which is cheaper than prescription opioids. Fentanyl is 50-100 times more powerful than heroin and is leading to lots of overdoses across the country because it is being mixed with street heroin.

 

[pais alto]

Anyway I'm sure actual patrollers have a million stories like this.

Actual patrollers?

 

[Monique]

Actual patrollers?

Someone like you, as opposed to myself, who is on no way a patroller.

 

[Monique]

One of the leading things getting people hooked on heroin is actually the OVER prescription of opioids. People become dependent very quickly and when then can either no longer get a prescription, or afford a prescription, they turn to heroin which is cheaper than prescription opioids. Fentanyl is 50-100 times more powerful than heroin and is leading to lots of overdoses across the country because it is being mixed with street heroin.

I would imagine it could go either way. If someone is already dependent, I'd rather they get clean drugs than street drugs.

Chasing the Scream is a book with a number of examples of programs allowing people to get clean drugs while dependent. Of course, anecdote is not data, etc. But I found it interesting.

 

[Dwight]

One of the leading things getting people hooked on heroin is actually the OVER prescription of opioids. People become dependent very quickly and when then can either no longer get a prescription, or afford a prescription, they turn to heroin which is cheaper than prescription opioids. Fentanyl is 50-100 times more powerful than heroin and is leading to lots of overdoses across the country because it is being mixed with street heroin.

And it won't be long before we all start caring Narcan too.

 

[mdf]

Even in the emergency room you have to wait for x-rays to get a dislocated shoulder reduced. (Last year my wife slipped in the kitchen and tried to catch herself on the counter behind her. ) Once they have confirmed it is just a simple dislocation putting it back takes 15 seconds.

 

[Monique]

That's like, the one injury I haven't had yet (slight exaggeration). Knock on wood.

 

[Dwight]

Even in the emergency room you have to wait for x-rays to get a dislocated shoulder reduced. (Last year my wife slipped in the kitchen and tried to catch herself on the counter behind her. ) Once they have confirmed it is just a simple dislocation putting it back takes 15 seconds.

Yep, because if the ball slipped under, you are getting knock out with meds to put it back in.