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Renson Report

Ski Safety

"SKI SENTINELS" NSP DOCUMENTARY
AVAILABLE RIGHT HERE,
RIGHT NOW (From: www.nsp.org)

The much-buzzed-about "Ski Sentinels: The Story of the
National Ski Patrol" documentary is now available
right here through the on-line NSP Winter Catalog,
item #17191. The 54-minute documentary, produced in
2007 for the New England Ski Museum, details the birth
of the NSP and captures pivotal moments in the
organization's history. The documentary takes viewers
from the early days of the NSP through the opening of
big mountains in the West and the advent of avalanche
control. Members can log in, click on the Winter
Catalog, and purchase the DVD for only $18.

Film's Role in Popularizing Alpine Skiing in America
By Richard W. Moulton

Background Article from the Sentinal film producer,
MRG's own skier/film maker Rick Moulton.
www.rickmoulton.com/articles/filmsrole.shtml



Report submitted by Mark Renson of the MRG Patrol
regarding the Eastern Division Fall Ave, MTR, Nordic Meeting.


I attended the annual AMN Instructor Meeting:  http://amn07.nmnsp.org Yup, it was 2 days (Sept 8th-9th).   This was held at the Northfield Nordic Center who played a big part in setting this up.  This meeting was exceptional and a very educational proactive 2 days.  I will share my notes as follows:Avalanche Training
 
I went through 6 skill stations.  Yes, this was like a refresher.  There were 2 each in Avalanche, MTR and Nordic.  Avalanche had beacon search and snow density, MTR had map reading including UTM vs. Lat/Long methodologies, Nordic had rescue sled and Pack List with the latter based on the Pennsylvania State Forest system standard list.  Avalanche Probe Line exercises were performed.
 
Avalanche
* 9 Avalanche courses in NSPEast planned for this year, making up for many that were cancelled from last year
* Revisions in the Avie Instructor manual planned for 2008-9 season
* 10 major beacons out there and we should decide on a standard one.  Chuck Boyd recommends using Ortovox as they have been very supportive of NSP and we should get the D3 and slowly phase out the F1.  [I cannot believe how much beacon technology has come over the last 5 years]
* J Shefftz beacon review was praised.  It was published in the Avalanche Review newsletter.
 
MTR
* Mention was made of making it snowshoe friendly.  Unfortunately, this could make travelling agonizingly slow. 
* Discussion was made over getting GPS integrated into MTR II courses.  GPS is good at telling where you were and are, but not good at getting you to a particular point - map 'n compass excels at that.
 
Nordic
* Senior Nordic exam to be held in Western Mass.   Exam includes building a rescue sled.
* MRG was very encouraging about last year's Nordic/Telemark event held there.  Greg France liked skiing with the patrol. 
* CREL seminar to be hopefully held; next April perhaps.
* 40th Anniversary of the Nordic Patrol coming up and there will be a celebration per Dave Hodgdon
* 300 Nordic Patrollers needed for the Vancouver Olympics and there probably are not nearly enough Canadians to cover this; go through the csps.ca website for info and remember that passports will be needed to cross the border.
* Nordic Master program being proposed; analogous to Alpine Certified program. 
* Possible backcountry type of certification in the future combining all 3 disciplines (Avie/MTR/Nordic).
 
Other
* Having a website helped get sponsors and once I got on, it was easier to get others - i.e.: if BCA got on the website, then Ortovox would follow and so on and so forth ....... Christian, could this be done for the NSPNVT site?  hmmmm ....
  
ICS
The following: http://training.fema.gov/EMIWeb/IS/is100.asp was mentioned as a good source of at least learning the buzzwords for ICS as well as providing info and training aids
 
Rick Toman from the Massachusetts State Police (MSP) gave a great presentation as well as supprting an ICS exercise.  Apparently, Massachusetts has a highly acclaimed ICS at the state level and Rick has been the mastermind behind much of it.  He is not a state trooper, but supports the MSP as a paid full time employee (lives in  Vermont and an apartment around Springfield MA is provided as part of his compensation).
* Recommends researching http://sarstatistics.org/ and pointed out that lost skiers will display different characteristics from other lost folks.
* Provided 2 forms used: "Lost Person Intake" which is what the Dispatcher takes on the phone (or whatever) and provides to the searchers when they are deployed.  "Lost Person Questionnaire" is a more detailed form which brings out the personal habits of the lost.  I could provide copies of these forms.
* In Massachusetts , law enforcement is responsible for Search and Rescue due to the high probability of a crime associated with lost people.
* Ski Patrol is key for SAR due to:  Local knowledge (critical), historical data on lost and found incidents at the ski area (i.e.: at Killington, the lost always seem to go to the same spot).
* Important to "segment a map".  This segmentation should be done based on topographical features.  Anything oustide of the segments is called ROW (Rest Of the World).
* MSP expects that when they come to a ski area, the following components of the ICS are in place:  Incident Command, Planning, Operations.
* Every search starts with PLS.
* If on a search you find evidence, do NOT touch it - place some flagging nearby.
* Since GPS is put in phones nowadays, it's worthwhile to get the phone company to ping that phone which will reveal the phone's distance from the cell phone tower.
* Ensure you have a safety plan in place for the searchers (guard against hypothermia, have a policy that searchers must wear crampons in steep icy terrain, etc) before the State Police arrives.
* Rick is a stickler for background checks.  For example, when a child is reported as lost, that will draw out the local pedophile club to volunteer in the search.  Think about that one when a kid gets lost in the 20th and someone ya' don't know volunteers to ski over there to help with the search.
* Use the Lat/Long methodology rather then UTM when doing orienteering - Lat/Long is the standard per the National SAR Plan and must be used when you interface with MSP
* Rick is a stickler for time - he has seen lives saved within minutes of probable death.  He cannot stand spending time to set up a staging area - a minute here, a minute there adds up.

Meeting commenced a little before noon on Sunday.
 
Again, this was a very worthwhile weekend.  I was the only Vermont patroller there.  The remainder came from as far away as Buffalo/Holiday Valley.  Many were there from Massachusetts , New Jersey , Pennsylvania , New York .  I learned new stuff and also what I do not know.
 
Mark P. Renson -- Return to Top


Ski Safety Research finds its Home in the Eastern Division

The following article was initiated from an inquiry from Clark Goodrich of the SNY Region to the ED BOD regarding ski safety and Ski Patrol.  Clark found a reference to the International Society of Skiing Safety (ISSS) of which Dr. Robert Johnson, ISSS Board Member, conducts research at Sugarbush Resort in Northern VT.  ED member Christian Jaquith is familiar with Dr. Johnson’s work and therefore conducted an email interview including questions from Clark Goodrich as follows:

Dr. Johnson,

I am writing to you regarding our phone conversation of April 10.  I had mentioned I was calling on behalf of the National Ski Patrol Eastern Division Board of Directors as the Northern Vermont Region Director to interview you regarding your work with the Vermont Ski Safety Group and International Society of Skiing Safety. Thank you for your time in answering our questions.
Christian Jaquith

My opening Question by way of introduction:
Q:  What is your involvement regarding the Vermont Ski Safety Group, its contact information, mission, and a short history?

Christian-
Let’s see how this interview can be helpful to your cause.  I will attempt to answer your question and future questions that you may have. 
A:  The ski injury project at Sugarbush, Vermont is really an ongoing epidemiologic study looking at the cause and affect of changes in skiing in general and skiing equipment specifically.  The mission is to identify those problems that result in unnecessary injuries and make attempts to mitigate such problems. 
The three principle investigators are; Carl Ettlinger who is the Director of Vermont Ski Safety Equipment Corporation; Jasper Shealey who is Emeritus Professor of Human Factors Engineering at the University of Rochester, and myself, Emeritus Professor of Orthopaedic Surgery at the University of Vermont, College of Medicine.  Our group began as a liaison between Carl Ettlinger and myself in 1972 when we set up the means of monitoring ski injuries and their causes at Glen Ellen ski area in northern Vermont.  A few years later Jasper Shealy joined us in our endeavor.  By 1980 we were running clinics in the base lodges of both Sugarbush North and Sugarbush South.  The study design involves a case control study in which data is gathered on injured skiers and the causes of these injuries. We evaluate the equipment and its function to determine if these factors may be related to the cause of injury.  Similar information is gathered from a representative group of uninjured skiers to be used as controls. The data obtained from these studies has been published in numerous journals and has been used as a basis for guiding the American Society of Testing Materials and the International Standards Organization as these organizations worked to develop consensus standards concerning skiing equipment with emphasis on safety concerns.   As we have continued to observe the trends in skiing injuries through the years we have noted that the improvement in skiing equipment has resulted in a dramatic reduction in the rates of lower extremity injuries  [as much of 90% in lower extremity fractures].  We have also, unfortunately, noted the inability of modern skiing equipment to reduce the risk of severe knee injuries which primarily involve the anterior cruciate ligament.  Although it is hopeful that in the not too distant future modifications in ski bindings may help reduce the risk ACL injuries, at this time we have shown that the only practical way to prevent ACL injury is to understand the mechanism of injury [phantom foot mechanism] and avoid those circumstances which lead to the production of these severe injuries.  We have shown in a study involving ski patrollers and ski instructors at 42 ski areas from all around the country that the risk of ACL injuries can be reduced by well over 50%  by simply understanding and avoiding the circumstances that lead to these severe knee injuries. Other important findings from our study involve the ongoing investigation of the trends in skiing and snowboarding activities that have changed the injury patterns through the years.  We were concerned that carving skis could possibly increase the risk of severe knee injury among recreational skiers but our studies reveal that there has been no profound effect caused by these skis.
We have identified a very dangerous trend which resulted from the recent introduction of very short skis with no release bindings. This led to an unnecessary resurgence in severe ankle and tibia fractures.  We have very strongly advised against the use of this type equipment.                                                                                                                                            It is our goal to continue to monitor the trends of snow sports injuries and if possible to      devise strategies to reduce the risk of injuries in these activities.

Members of our ski safety group can be contacted by email as follows:
Robert Johnson, M.D. Robert.Johnson@vtmednet.org
Jasper Shealy, Ph.D. Jeseie@rit.edu
Carl Ettlinger, MS vsr@together.net

A summary of much of the information that we have published through the years can be obtained from Carl Ettlinger’s web site which is http://www.vermontskisafety.com/.

Q:  Dr. Johnson, you sit on the board of the ISSS, can you describe your role in that organization, history of that group, introduce the major members, describe their annual meetings and briefly summarize the papers you have presented and their ramifications?

 

A:  Please find below a history of International Society of Skiing Safety (ISSS). My personal role in this society has been to be a founding member. I was president of the society from 1989-1997 and have been on the board of directors of this group since shortly after its beginning. I have also served as the editor for a series of Special Technical Publications of peer-reviewed articles developed from presentations given at the meetings held every other year. A book has been published every other year since 1985 under the auspices of the American Society of Testing and Materials (ASTM). My own personal research efforts have been generated from an ongoing epidemiological study carried out at Sugarbush resort since 1972. Our major goal is to evaluate the trends of skiing injuries, identify risk factors and explain the relationship of equipment (ski boot binding systems) to the production of injuries. Information used from our research has been applied to the development of safety standards at the national level through the American Society of Testing and Materials and the international level through the International Standards Organization. We have identified a major cause of knee ligament injuries, primarily to the anterior cruciate ligament, and the means of reducing the risk of sustaining these.

My co-investigators are Carl Ettlinger of Vermont Ski Safety Equipment Corp. and Jasper Shealy of Rochester Institute of Technology.

Taken from the overview of the most recent ISSS/ASTM publication:

Skiing Trauma and Safety, Fifteenth Volume

The International Society of Skiing Safety was founded as result of the 1st World Congress on Skiing Safety that was held in Riksgransen, Sweden, in 1974. The organization of the Society was instigated under the enlightened leadership of Ejnar Eriksson, MD, of the Karolinska Hospital in Stockholm, Sweden. The second meeting of the society occurred in 1977 in the Sierra Nevada of Spain and has been held biennially ever since. The subsequent meetings occurred In Queenstown, New Zealand in 1979, Bormio, Italy in 1981, Keystone, Colorado, USA in 1983, Naeba, Japan in 1985, Chamonix, France in 1987, Riksgransen, Sweden for a second time in 1989, Thredbo, Australia in 1991, Zell am Zee, Austria in 1993, Voss, Norway in 1995, Whistler/Blackcomb, British Columbia, Canada in 1997, Breuil Cervinia, Italy in 1999, Queenstown, New Zealand in 2001, St. Moritz/Pontresina, Switzerland in 2003, and Arai, Niigata, Japan in 2005. Planning is now underway for the 17th meeting of the ISSS to be held in May, 2007, in Aviemore, Scotland under the direction of Dr. Mike Langran.

The primary purpose of the Ski Trauma and Ski Safety Congress is to bring together a wide variety of individuals interested in all aspects of snow sports safety. These meetings have served as a format for the presentation of a multitude of subjects concerning snow sports including the means to prevent injury and improve various aspects of the sport and the treatment of injuries. A major accomplishment of each of these meetings has been the publication of the presentations given during the congresses. Since 1983, with the cooperation of the American Society for Testing Materials (ASTM International) Committee F27, we have published a book containing papers given at the congresses. These publications have continued to be the primary source of information for all of those interested in winter sports safety. Following the 1999, 2001 and 2003 meetings, abstracts of the papers presented at the congress were published in Knee Surgery, Sports Traumatology and Arthroscopy.

Attendees of the symposia of skiing trauma and safety have included representatives of the skiing industry such as binding, boot and ski manufacturers, engineers from industry, universities and technical institutions, skiing professionals such as ski instructors and patrolmen, physicians, lawyers, ski area managers and participants in recreational and professional skiing and riding activities. Interchange of ideas, comments, and critiques are encouraged in formal discussion of the papers. Many of the individuals who attend these meetings are involved in the ASTM International Standards process or those of other national and international standards organizations and are members of the International Society of Skiing Safety but all interested individuals are encouraged to participate.

All authors who present papers at the meetings were encouraged to submit their papers in a manuscript form to be considered for publication in a Special Technical Publication (STP) and now the Journal of ASTM International (JAI), which results from the peer review and editorial processes of the ASTM International. We believe that this ongoing effort has produced the standard for the world in the assemblage of a relevant body of literature dealing with safety in winter sports as well as the prevention ad treatment of injuries sustained by participants in these activities. The fundamental goal of both the International Society of Skiing Safety and the American Society for Testing Materials International Committee F27 on Snow Skiing is to improve the sport of skiing and associated activities by reducing the risk of injury and producing better and more enjoyable means of participating in all these winter snow sports activities.

The interrelationship between the International Society of Skiing Safety and the American Society for Testing and Materials International has results in a unique method for providing a forum for the discussion of problems of winter sports safety and the publication of a state-of-the-art book such as this Special Technical Publication. When it was initially organized, the goal of the ISSS was to primarily address the problems of alpine and Nordic skiing safety, but through the years the scope has changed to include freestyle skiing, snowboarding, ski boarding and other hybrid activities that occur on the slopes of the world’s mountains. The goal remains to identify the risks and the means of reducing risks in these activities. We encourage all who are interested in these snow sports to join us in the future as we seek to improve their quality and safety.

 

In response to the questions posed by Clark Goodrich:

Q:  Can patrollers help collect snow sports injury data on the mountain without violating any laws?

A:  The answer to this question is definitely yes. The patrollers are already requested and required to fill out accident reports. The best thing they can do there is accurately fill these out so that they can be used for future research. No laws are broken by the present attainment of data. Several of the studies that we have done have queried ski patrol data at numerous ski areas around the country. How this is specifically done could probably best be asked of Jasper Shealy, who has done most of the work in using ski patrol data to produce a series of papers. His e-mail address is jeseie@rit.edu

Q:  How can NSP help improve snow sports safety?

This is a very broad question and I really don’t have a very specific answer to it. Proper collection of data as mentioned in question 1 would be a major factor along these lines. Also, educating skiers that are perceived as skiing outside the norms of the skiing safety code could be another way that ski patrol could on a day to day basis assist in the improvement of snow sport safety. It would probably be very wise for a member of the NSP to attend some of the ASTM meetings, which are held twice a year North America and also to attend some of the upcoming International Society of Skiing Safety meetings to be held every other year at some major ski resort at sites throughout the world. Thus, they can probably best answer this question by understanding the way the ASTM works and also to hear first-hand the papers that are presented at the ISSS meetings and join in the discussion as we all strive to reach the goal of safer skiing.

Q:  Can NSP members interested in data analysis obtain ski injury data collected by members of the ISSS Congress Board?

 A:  The publications that are out are somewhat difficult to get but many of the more recent ones could still be obtained. In recent years they have been published as soft-covered books containing 8-20 articles that are peer reviewed and published in this format. Abstracts of other articles beyond those which are published have also been published in a European medical journal over the last 6 years. These abstracts number somewhere in the 20s and give a summary of the material that is presented at the ISSS congresses. I could help you get these if you so desired.

Q:  Has HIPAA made it more difficult to collect skier and snowboarder injury data?

A: Although the answer to this is yes, it has made it more difficult, from our standpoint these are not major obstacles. They just require more paperwork. We have to go through a very specific process through the Internal Review Board of our hospital which requires us to follow very stringently these rules. This has caused us to generate a lot more paperwork but we still are able to get this data with a minimum of difficulty.

Q:  Given the significant change in ski equipment in the last 3 years, what are the trends in ski injuries after 2003 compared to ski injuries prior to 2003?

A:  I agree that there are rather dramatic changes in skiing equipment as far as the ski is concerned. We were concerned that there might be an increase in certain lower extremity injuries, especially knee ligament injuries, including the anterior cruciate, when the shorter skis came into popularity. However, our epidemiological investigations have not shown an increase of any injury type that could be based on the better carving capabilities of the newer skis. The new bindings have actually changed the mechanics of the release capabilities very little and we have not observed any specific change in relation to binding function such as a breakthrough in protecting a skier from knee injuries. This simply has not occurred. We have noted a trend in the last few years of less compliance with standard shop practices concerning mounting and maintaining ski boots and appropriately testing them, although these are only minor issues. This trend, if it worsens, could lead to a higher number of lower extremity injuries. One development over the last several years has been the use of very short skis (ski blades) without releasable bindings. We have found this to be a very unfortunate trend because there has been a significant increase in ankle fractures and tibia fractures because this equipment cannot avoid injury to these structures and we have very strongly advocated, based on our epidemiology work, that the use of this equipment should be discouraged.

Q:  Has there been any trend changes in the number of injuries involving trauma for either skiers or snowboarders in recent years?

A:  As I stated above, there have been no major trends except the ones I alluded to. There is some evidence that there has been a significant but still relatively minor decrease in the incidence of ACL injuries that are occurring. This could be related to the shorter skis and perhaps some people having a better understanding of how to avoid the most common ACL injury mechanism, which we have termed “The Phantom Foot” mechanism.

One Last Question in closing (Christian):

Q: Dr, Johnson, the Vermont Ski Safety Group has compiled it’s efforts in studying Ski Injuries by producing an ACL Awareness Video is that still available?

A: Yes, The ACL Awareness video can be attained by contacting Carl Ettlinger at the web site-- http://www.vermontskisafety.com/.

 

I hope that the above information has helped at least start a dialogue that you may wish to pursue further.

Sincerely,

Robert J. Johnson, MD
McClure Professor of Musculoskeletal Research
University of Vermont College of Medicine
Department of Orthopaedics & Rehabilitation
Robert.Johnson@vtmednet.org

The Board of Directors of the Eastern Division of the National Ski Patrol would like to thank Dr. Robert Johnson for contributing his time and expertise for this interview.
"Although NSP's mission is to provide quality focused education and training in snowsport safety, NSP is not affiliated with the International Society of Skiing Safety.  The Eastern Division of NSP hopes to continue working with the International Society of Skiing Safety to promote our common goal."  

Christian Jaquith   Granville, VT  May 15, 2006

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