Accidents occurring in remote mountainous environments are complicated by many factors. Time to inform the emergency services may be prolonged, as may time for evacuation to hospital. The medical assessment and treatment of casualties is made more difficult by weather conditions, poor light, limited equipment, and limited assistance. The commonest problems are, as one would expect, lower limb injuries. The role of the doctor An appropriately experienced doctor can bring unique skills to mountain casualties.
Patient assessment is likely to be more rapid and accurate when performed by a doctor.
The doctor can administer effective analgesia intravenously and drugs for medical emergencies and can provide invasive skills such as cannulation and advanced airway management. Another important role for a doctor may be to decide to transport the casualty directly to the most appropriate facility for definitive care, rather than simply the nearest hospital, especially if a helicopter is being used for evacuation. In the event of fatal incidents, doctors also have the ability to pronounce life extinct at the scene. This helps the work of the police and may remove the need for inappropriate resuscitative efforts being continued until the casualty arrives in hospital. The mountain rescue doctor also plays an active part in medical training for other team members.