In the event of a rescue or an emergency, the guides will manage the situation along with the mountain rescue team (on the south side only) using mobile phones, as there is some signal on the mountain. However above the Saddle there is no signal so any situation above that point has to be self-managed.
A rescue will involves an assisted descent down the mountain using primarily the tracked vehicles and manpower on the south side, and only manpower on the north side.Snowmobiles and ratracks can get up to 5000m in the right conditions and take casualties to the chair lift. Theoretically someone could be down in the valley in a matter of a few hours.
If climbers on the north side have travelled through the col then it would be sensible to descend the south side to the village. Otherwise, an injured person would need to be assisted all the way back to the snowline at the top hut which would be very difficult.
Casualties are generally taken to the nearest hut and kept warm and safe until a decision is made to move further down the mountain. On the south side, this can be done with the ratrack vehicles and then transferred to the cable cars to get to the village in less than an hour. On the north side, an injured person would need carried or assisted with manpower to the base camp and then taken by car to the nearest town and hospital which adds further hours to the evacuation.
For all of these evacuation scenarios there is no external assistance, and a helicopter is not a possibility because of the difficulty of landing on the mountain at high altitude. Every rescue becomes a group responsibility and other mountain guides will help. On Elbrus the mountain rescue team is made up from all the local mountain guides and during the season there will always be other people to help and rely on. Inevitably the snow cats play a big part in rescues.
Common reasons for rescue are exposure due to the cold, exhaustion and collapse due to a combination of the cold, tiredness and altitude.