The Bear Creek EMS Program is hosting the following virtual class.
Assessment of Chest Pain – June 23, 2026 – Virtual
Presented by:
Dr. Steven Goldblatt, MD, FACC
Cardiologist (Retired), Medical Officer, Team CT-1, Disaster Medical Assistance Team,
and Medical Advisor for National Ski Patrol’s Eastern Division.
Eric Snyder
EPA Inter-Agency Liaison (EMS)
(610) 487- 4479
epaemsadvisor@gmail.com
nspepa.org
Now about to conclude its second season, the advanced life support (ALS) pain management program at Stratton Mountain in the Southern Vermont Region has already helped numerous patients with moderate to severe pain while still on the mountain with injuries.
The program, known internally as “Code 90,” was started during the 2024-25 ski season at Stratton Mountain Ski Patrol (SMSP). We saw a need to help our patients with painful injuries while still on the mountain utilizing advanced life-support-level care and pain medications. This was made feasible as SMSP also operates Stratton Mountain Rescue (SMR), a Vermont-licensed ALS ambulance service which serves the Stratton Mountain community and surrounding areas during operating hours throughout the year. Essentially, SMSP/SMR extends the scope of practice and capabilities of the ambulance service onto the mountain to be able to provide ALS-level pain management to injured guests.
The Code 90 Team consists of four paramedic ski patrollers as well as one licensed physician anesthesiologist who is also a ski patroller. The paramedic ski patrollers operate under standing orders of the Vermont Statewide EMS Protocols and work in coordination with the Carlos Otis Stratton Mountain Clinic; an urgent care center located in the base village staffed by emergency medicine physicians and orthopedic surgeons during the ski season. Patients are transported off the mountain by sled and then transferred to the Otis Clinic for further care.
If patients require transfer to higher level facilities, this is accomplished by Stratton Mountain Rescue Ambulance (staffed by ski patrollers). When necessary and weather permitting, our dispatch will request a medivac helicopter for critical care interventions and rapid transport to a Level 1 Trauma Center. Stratton Mountain has a designated Landing Zone that is easily accessible nearby to the clinic throughout the year and secured through Stratton Security or local fire/rescue personnel.
For all reported incidents on the mountain, ski patrol dispatch (located at Patrol Headquarters at the Summit) will initially send one ski patroller to respond directly to the scene. The first responding patroller will assess the patient and request additional resources, patrollers, and equipment as the situation requires. This also may include requesting a “Code 90” for patients with moderate to severe pain if they may need pain management. Ski patrol dispatch will then locate and send a member of the Code 90 Team, if available, to the scene.
The Code 90 Team member will assess the patient further and, if appropriate, administer Fentanyl, a synthetic opiate, to reduce the patient’s pain during splinting, extrication, and sled transport to the clinic. This can be accomplished via multiple routes including intravenous, intramuscular, and intranasal routes. If the intravenous route is preferred, an IV is established on scene on the mountain.
To ensure readiness, ALS patrollers sign out a narcotic kit from a designated safe each morning and, if not used, return the kits after sweep. Restocking of medications is accomplished at the Otis Clinic. Data are tracked for each patient. SMSP is observing significant improvement in patients’ reported pain averaging a five 5-point reduction in pain scores (utilizing the numeric “1-10” pain scale). Every call is reviewed by the team with participation of the Otis Clinic Medical Director, Ricky Kue, MD. Call data are also entered into the Vermont EMS Data System (“SIREN”).
ALS kits also contain naloxone (NARCAN®) as well as ondansetron (Zofran®, an anti-nausea medication) to manage any side effects. As a precaution, an oxygen pack containing additional equipment including airway management, suction, and epinephrine kit and bag-valve mask is also sent to all Code 90 calls. The Code 90 Program is also available at times during the summer season at the Stratton Mountain Bike Park depending on staffing. Currently, this SMSP makes an effort to have Code 90 Team Members on the mountain and available as many days as possible, but is not guaranteed due to staffing. The program is considered “Best Effort” in terms of availability.
Next season, through a generous equipment donation, SMSP is working toward approval to add the capability to also administer nitrous oxide to patients on the mountain as a part of the program. This option will also be available to not only the paramedics and physicians but also Advanced Emergency Medical Technicians (AEMTs) on ski patrol, increasing the availability of the program.
Our goal is to be able to treat as many appropriate patients as possible. While quite common in the west, as was found at my previous ski patrol at Vail, this type of program is somewhat unique in the east and SMSP is happy to offer this service to our guests when needed to make their unfortunate situation a little better.
Marc Burdick has been ski patrolling for 40 years and is currently a paramedic ski patroller at Stratton Mountain Resort. He is a critical care paramedic with Northern Berkshire EMS in North Adams, Massachusetts where he manages special projects.
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
While I was editing the current Instructor Guide I thought back at my own various exposures to MCI events over the course of my experience beginning in the mid-70s as a young ski patroller at one of the first half dozen major US ski lift accidents. I have worked in both ski patrol and EMS since 1973.
I recall that first incident with feelings of sheer panic. I was 18 years old and assigned to gather and deliver equipment to the scene where a dozen skiers were injured and more trapped. My role was clear and within my capability, a quite necessary role. Nonetheless, I was left with a feeling of inadequacy and achievement. Reflect on that for a moment!
Since then, I have attended training for large scale MCIs—airplane crashes, shootings, bus accidents, hazmat incidents, and more. All these exercises were chaotic events, each a learning experience. Even when the outcome is positive, the event is frenzied.
These are the “Dress Rehearsals.” I have been involved in real-life, smaller-scale MCIs—multiple vehicle accidents, bus accidents, chemical spills, a nursing home fire, and a small explosion. The results continue to be controlled chaos with productive outcomes.
The thought of a major event still leaves me with a feeling of trepidation. The point was and is, even in an exercise, expect the chaos, expect the trepidation. It is going to happen!
The NSP Certified Program is a performance-based leadership program that provides an opportunity for patrollers to learn and be tested on critical patroller skills/knowledge. The program has a distinguished history with many of its members serving in national, division, regional, and local patrol leadership positions. Certified patrollers have a history of commitment to giving back, fostering learning, and progressing core patroller skills over the years.
Success in the program is hard-earned, requiring a real commitment to mastering multiple patrol-related disciplines, often over multiple years, across regions and divisions, to gain a vast and deep knowledge/skill base. Through the program, our members not only build a best-in-class level of expertise but also a sense of camaraderie with fellow patrollers as they work outside their local patrol/region.
Your preparation to participate will provide a unique opportunity to learn from others, broaden your experience, and sharpen your skills. Admission is not automatic. To apply as a candidate, an applicant’s credentials are reviewed by a committee to ensure a minimal level of experience, a commitment to the program, and a track record of leadership and support of their local patrol/region.
Qualified individuals are invited to participate in the annual certified exam. This exam is an intensive 3-day event that tests all aspects of your patrolling skills. During the season, multiple events are hosted, including a summer boot camp, to help hone skills and prepare candidates to be successful.
The Certified Program has six core components examining physical endurance, knowledge, and experience, all requiring individual study and travel. The six core components are Avalanche, Outdoor Emergency Care, Outdoor Risk Management, Rope Rescue, Skiing and Riding, and Toboggan Handling. The specifics of each component can be found below in a document titled Certified Program Operations Manual.
This member-driven and approved standard is without compromise, where excellence is mandatory and the contents of exams are constantly evolving to remain current with best practices and industry standards.
Over the past years, we have concluded that we make great patrollers even better through a combination of training, education, and teaming opportunities. We are working hand in hand with the National Ski Patrol to develop future leaders and excellent patrollers. We have a significant pipeline, and we continue to engage and expand our reach into the ranks of the NSP, including active participation in all levels of training, testing, leadership development, and diversification of the NSP across every program offered.
It’s that time of year again to plan your summer/fall patrol activities. Two of our favorites are back this year: Certified Boot Camp and Enhanced Patroller School. Both promise new adventures, team-building opportunities, and activities that will definitely stretch your skills and thought processes.
Last year’s Boot Camp events included fundamental first aid, mass casualty and triage skill development, new and creative approaches to lift evacuation skills, mountain operations, tower climbing dos and don’ts, outdoor risk management, avalanche fundamentals, and low-angle rescue. Our event was hosted at Holiday Mountain Ski Area in the Southern New York Region. It provided unique insights into what it takes to “open” an abandoned ski resort. Thanks to Mike Taylor, a fellow patroller and new owner of the resort, for being a gracious host and a brave entrepreneur.
Highlights from last year’s Boot Camp include:
• A Friday night lift evacuation exercise with all participants assigned a role in a simulated lift evac. The players included state and local officials, mountain management, resort operations manager, lift maintenance, and patrol. The scenario was presented to the participants through role-playing. All in attendance gained valuable experience in understanding the roles and responsibilities associated with lift evacuation. We all gained new appreciation for all the players involved in a lift evacuation.
• An ORM session led by certified patroller and mountain manager, Ted Davis, from Ski Windham, and
• A discussion of certified credentials held late on a hot day in the river, allowing for a refreshing discussion of the topic.
2025 Boot Camp
This year’s Certified Boot Camp will be hosted by Ski Roundtop, a Vail resort located just south of Harrisburg, PA. Activities will include a ropes course, camping by the lake, paintball opportunities, and unique insights into the operations of a Vail Resort, as well as:
• Your “normal” OEC, LE, LAR, and Avalanche activities.
• Friday night will include a visit from a local taco truck vendor.
• The usual chefs will be in the house, including Steve Suomala and Jimmy O’Connor, and their famous breakfast burritos.
• There will be a special visit from past certified chair and Elk Mountain patroller Billy Jordan. He will be catering the Saturday night potluck with his world-famous barbecue.
• If you want to make it a long weekend, Hershey Park is only 20 minutes away and is an awesome amusement park.
• Details for the Certified Boot Camp are:
̶ Ski Roundtop, Harrisburg, PA
̶ Visit patrollerschool.org for more detailed information and upcoming registration
̶ August 15-17
̶ Arrive Friday from 4-6
̶ Depart Sunday 2-3
The Genesee Valley Region has set the date and location for its popular Enhanced Patroller School. It will be held September 12-14, 2025, at Swain Resort. This great summer training event allows patrollers to work on various patroller skills, including many aspects of the OEC program, chairlift evacuation techniques, low-angle rescue methods, and rescue knot tying. The weekend culminates with a simulated mass casualty incident on Sunday morning, bringing together all the skills reviewed during the previous two days. Many of the skills covered are part of the NSP Certified Patroller Program.
Last year’s event, also at Swain, was attended by 53 participants and 12 gurus whose task was to help guide the various stations. These patrollers came from 23 patrols, 12 regions, nine states, and had a combined total of over 800 years of patrolling experience. Additionally, several outside agencies also participated in the simulated mass casualty Incident on Sunday, including:
Thanks to our Helpers!
Allegany County Office of Emergency Management
Alfred Station Fire Company
Canaseraga Fire Company
Dansville Ambulance Company
Medical Transport Service, Inc.
Canaseraga Ambulance
Fillmore Ambulance
Nunda Ambulance
Allegany County DC 4
Jeff Baker and Tom Wallin have been organizing these training events since 2011. Jim Nickerson and Joe Menichino have been planning and working since the beginning. From year to year, they bring in additional patrollers from around the division to help act as guides and gurus because they have expertise in the different modules they are planning. This school has always been a low-pressure, hands-on, try stuff, get your hands dirty (or bloody), and ask questions type of event.
They have always wanted it accessible to patrollers of any level, including candidates, basic patrollers, senior candidates, and senior and certified patrollers. They want everyone to have fun, learn stuff, and take ideas back to their home patrols. With patrollers coming from around the division, as you sit around the fire pit talking at night, you get an interchange of ideas and techniques from many other patrollers.
Jeff Baker patrols at Bristol Mountain, Tom Wallin and Joe Menichino at Swain Resort, and Jim Nickerson is an alumnus patroller from Hunt Hollow Resort. To register for this event, go to NSP’s Center for Learning, browse the catalog, and search for Patroller Enrichment Seminar/Genesee Valley/Swain Resort.
2024 Enhanced Patroller School Staff – from L-R; Jonathan Smith-Pittsford Ambulance, Glenn Becker-Bristol Patrol Director/Penfield Ambulance, Jeff Baker-Bristol Patrol/Pittsford Ambulance/Lifetime Certified, Jim Nickerson-Lifetime Certified, Joe Menichino-Swain & Bristol Patrol/Lifetime Certified, Jesse Merdak-Pittsford Ambulance, Tom Wallin-Swain Patrol/Lifetime Certified, Steve LaDue-Hunt Hollow Patrol/CHS Ambulance, Rob Armet-Windham Patrol/Lifetime Certified.
Every March, without fail, I look forward to the Eastern Division YAP Summit. It’s a significant event for many young adults, but I’m just like them—eager to hit the slopes, ski the trees and bumps, and find the good trouble we can get into. I’m always excited to learn something new (you’re never too old to learn something new), to watch the YAPs in the enhancement track gain confidence and knowledge in just three short days, and to see the competition groups cheer each other on. Of course, the awards banquet is always bittersweet. I’m never quite ready for the weekend to end, but I’m thrilled to see where the YAPs place and what cool swag they win. It’s truly an honor to return each year as a shepherd—arguably the best role anyone can have over the weekend, aside from being a YAP.
At the 2025 Summit, the staff decided to try something completely different—something far from the usual outdoor evening activity. The groups had the unique opportunity to create their senior-level scenarios and run them as instructors. Various chaperones, staff, and other adults were invited to participate as patrollers on the scene. For those fortunate enough to be there, well, it’s one for the books. Kudos to the creativity of these young adults!
A kind parent shared a few words about their YAP, whom I had the honor of shepherding and chaperoning—someone I hadn’t met before the event. This will be marked as the weekend she learned how to ski the bumps!
From the parents’ perspective
—I just wanted to thank you and your team for such a great event this past weekend.
—My daughter had a fabulous time.
—She made great friends, challenged her skills, and significantly grew her confidence.
—She is already excited to sign up for next year.
—I thought the event was extremely well-organized and well-run.
—Everybody was so nice and accommodating. I felt 100% comfortable letting my daughter go and do her thing.
—Your hard work did not go unnoticed.
—I cannot say enough good things.
—Have a great rest of the year and see you next year!
—Thank you again for such an amazing program.
Did somebody say SWAG?
This year didn’t fall short of being amazing. There was great skiing, fantastic OET and OEC instructors, and, best of all, an OUTSTANDING group of Young Adults! This year’s event was the largest by far, with 83 YAPs! That may seem like a large number, and no doubt it is, but over the weekend, shepherds get to know all their YAPs and unique backstories. We are truly fortunate in the Eastern Division to have such a strong program, where the hard work of the staff at every level—from division, region, and mountain—culminates in an event like this, reflecting the dedication and effort that flows through this division program. This is the future of our division; these are our future leaders.
Peter, Becky, Vinny, RJ, and Certified Program Chair Bill Zink
The Eastern Division recently held our annual Certified exam and banquet at Jay Peak with over 118 participants lying in the snow as OEC patients and observing our eight candidates show their stuff in skiing, toboggan skills, lift evacuation, low-angle rescue, avalanche, and outdoor risk management. Of course, Jay Peak delivered an excellent venue, terrific skiing, and amazing and challenging terrain. Four of the eight candidates were successful. They include Vinny Romano #870, Becky Rubin #871, Peter Buss #872, and RJ Bouchard #873.
A heartfelt congratulations to all four of these candidates. Vinny, Becky, and Peter were in their third and final year to be successful. RJ was in his second year. These new Certified Patrollers represent the Eastern Division well. They hail from Western Pennsylvania, Western New York, Connecticut, and Vermont resorts. These new members are already in leadership positions across the division, and we look forward to seeing their contributions in the future.
The Certified Program is a performance-based leadership program that provides an opportunity for all patrollers to learn and be tested on critical patroller skills and knowledge. The program history dates back almost 60 years, when the national chair requested some East Coast patrollers develop a leadership program that would span both the volunteer and professional patroller organizations and skill sets.
Upcoming events include a summer boot camp in the EPA region in August. Specifically, Vail Resort Ski Roundtop in Harrisburg, PA, will host us from August 15-17. The Enhanced Patroller School will also be offered again at Swain Ski Resort in Genesee Valley Region on the weekend of September 12 – 14. Both events will challenge the instructors and participants in all their skills and offer great camaraderie and adventure. Next year’s exam will be at Sugarloaf, Maine, in March 2026.
Again, congratulations to our newest Certified Members!
