In mountain rescue, the moments between injury and definitive care can determine outcomes. The Regional Mountain Trauma System (RMTS) was founded to strengthen every link in that chain. From the ski slopes to the trauma bay we work to connect ski patrols, EMS providers, and trauma centers through shared communication, education, and feedback.
RMTS grew from the recognition that mountain trauma presents unique challenges. Response often begins miles from the nearest road, in terrain where evacuation is slow and resources are limited. Once a patient reaches the hospital, vital field details can easily be lost. RMTS closes that gap by creating a seamless continuum of care, ensuring that ski patrollers on-scene expertise directly informs hospital treatment—and that trauma center insights return to the mountain.
At the program’s core are monthly multidisciplinary case reviews bringing together ski patrols, EMS crews, and trauma teams. Each session centers on a real incident, whether a high-speed ski collision, a snowmobile rollover, or a mountain bike crash, and asks not just what happened, but how we can improve next time. These discussions generate practical, mountain-specific education that can be immediately applied to all mountains in the region. The sessions are intentionally collaborative and non-punitive, fostering a shared language of care across all levels of the response system.
Perhaps RMTS’s most powerful innovation so far has been the creation of the Mountain Trauma Dashboard. The dashboard represents a centralized data system that tracks the incidents, type, and severity of mountain-related injuries throughout Western Massachusetts. Built through integration with hospital trauma registries at Berkshire Medical Center and Baystate Medical Center, this tool provides near real-time insight into injury patterns originating from participating mountains. It allows both resort patrols and trauma centers to recognize trends in mechanism and outcome, identify clusters of serious incidents, and target education or equipment changes where they are most needed.
A two-part MIST form was designed to be used for medical transport. One copy stays with the patrol, and one goes with the patient/EMS crew, and it is provided to the trauma team doctors, so the patient’s initial assessment is preserved.
By aggregating and analyzing this data across the season, RMTS can provide mountains with evidence-based feedback about patient outcomes long after they’ve left the hill. For example, when the dashboard identifies higher-than-expected rates of chest injuries in the region, RMTS can coordinate a focused case review or training session addressing splinting, pain control, or transport decisions related to those cases. This closed-loop feedback transforms anecdotal experience into actionable information, directly improving safety and response efficiency across the system.
The program’s reach also extends beyond the winter months. As many resorts transition into summer adventure parks, RMTS continues to track warm-weather injuries among mountain bikers, hikers, and climbers. By monitoring data year-round, the system identifies how terrain, weather, and usage patterns influence injury types, helping patrols adapt staffing and safety measures across all seasons.
Each fall, RMTS collaborates with ski patrols during their preseason annual OEC refreshers, sharing the latest clinical insights, updated trauma guidelines, and lessons drawn from dashboard data. Trauma surgeons and EMS educators participate directly in these sessions, reinforcing a culture of continuous learning and pre-season coordination between hospitals and mountains.
The lessons so far are clear: effective mountain trauma care depends on systems, not silos. When patrollers, paramedics, flight crews, and trauma teams share information and understand each other’s realities, outcomes improve. Small changes — like improved communication loops or data-driven insights — translate into faster transport, better triage, and safer recoveries for injured mountain athletes.
As RMTS continues to evolve, its vision remains focused on building a replicable model of integrated mountain medicine. The mountain environment will always be unpredictable, but with shared learning and collaboration, the care we deliver can be consistently strong, coordinated, and ready for whatever the slopes bring next.
If you would like more information about the RMTS program contact Mark Kryskow.
Jacques Townsend, DO, Baystate Medical Center
Seth Bernard, DO, Southwestern Vermont Medical Center
Mark Kryskow, DO FACS, Berkshire Medical Center, US ARMY Reserves
Peter Alusitz, Western Massachusetts ROA
Kevin Zorda, Western Massachusetts STC
Bill Welch, Western Massachusetts contributor
