This season, I had first hand experience of being a patient with a ski injury, and here is what I learnt.
As a ski patroller we often take casualties off the ski resort and into the medical centre. We treat them, get them stable and comfortable, perhaps with some pain relief, then we take them down the hill. Very rarely do we become the patient.
In early spring conditions I went looking for a snowboard on a creek line of a quiet run. Shaded by trees and with melt freeze, rock hard snow I proceeded down. Next thing I know I am face down with one ski off. My inside ski caught on some concrete and I went forward over my skis.
Lying on the floor face first I spent a moment to gather myself. A self examination and motion test was quick to reveal that my right shoulder had been dislocated. I wasn’t going to sit up, let alone get myself out, so I called up on the radio to get some help. I stated my position and injury without using codes to be clearer, and my call was given the 10-4 message understood, and I contemplated my next move.
After about 20 minutes I began thinking something was wrong, it only takes about 4-5 minutes to grab gear and get to my location. So I picked up the phone and called patrol. To their dismay they had misheard my call and thought they would sort it out when I returned to the top. Patrollers were dispatched immediately.
Now I find myself wondering if an app that can report my position straight into dispatch on a screen could have prevented that miscommunication. Had we have used this the passage of time to get to me would have been significantly less.
After a short wait, the first patroller arrived with pain relief, helped me to sit up and get set for a sling. The sled and our supervisor came down to attend, with the latter concerned about how to get me out of this tricky spot amongst rocks, a creek, and trees – all across some very slippery hard pack snow. As I was being loaded many discussions were held about egress route choice.
Moving off we (I say we, not like I was helping!) required some delicate manoeuvring, lots of man handling of the 150kg of cargo, and some lots of communication to get out of this difficult spot. The particularly gnarly final berm coming onto the slope gave me a bump, and lots of pain. I suspect, although we will never know that this is when I sustained the bulk of my injury – because it was the first time I felt the pain I see on so many casualties.
At the medical centre I was given pain relief, a reduction, and x-rays. This left me in a sling for about 3 days and unable to move the joint.
I am very happy that I have great mates, and professional patrollers around me (volunteer and paid) that came to my aid, and kept me safe coming down. Thanks James, Jock, Johnny and Matt – I owe you boys one.
At this point I am about 8 weeks past the event, and can work ok. I still have limited movement and am doing physiotherapy until a second specialist appointment in another two weeks. This will result in a decision for surgery. That could mean 6 weeks of immobilisation unable to work and 6 months of physiotherapy.
So, what did I learn?
1) Follow protocols:
I should have used codes on the radio as per our protocol.
2) Never assume, always ask:
The other end of the radio should have asked to get my message repeated as they didn’t understand it, they assumed I was fine.
3) Don’t underestimate patient comfort
Patient comfort is something we undervalue in return for speedy / easier exit
4) Time is always critical
Time is critical in all injuries and could have been cut down in this instance – so be efficient, but don’t rush
5) Be careful with terrain choices
Terrain choice is huge, and even small bumps can aggravate an injury and delay full recovery, but you will almost never know that.
6) Patients are not patrollers
I was not in massive pain, nor stressed, because I knew what had happened and how I was getting out. Patients are not patrollers.
7) Keep your patient up to date
Talk to your patient, I knew what was happening, but I was also told about it anyway – it’s great to know how it all happens
Finally, no technology is perfect, but in this instance I was reminded that we now have more modern options for communications. Radio’s are still really useful, but at least an app integrated to a dispatch system would have made it very simple to send out a patroller immediately to an exact location, rather than twenty minutes later.
Have you been a patient with ski patrol? What did you notice about the experience?