Ski instructor course 6: Disaster on the slopes

Two skiers collide at high speed on a windswept mountainside. What do you do?

First aid after a simulated accident on the pistes in Verbier

Don’t worry, this is only a simulation

At a junction between two pistes, four skiers collide at speed. Skis and poles go flying, the skiers bounce across the snow and come to a halt. They appear lifeless. What do you do?

Many of us would rack our brains for memories of that first-aid course years ago. We would probably also wish we knew the local emergency phone number.

Today, as part of our training to become ski instructors, we are doing a weekend course in first aid – and the carnage on the snow is simulated.

Christine Gillespie, ski patroller from Glencoe, gives a first-aid course in Verbier

Christine Gillespie demonstrates how to tie a head bandage on Alan Smith

We stick crossed skis in the snow as a warning to others, and attempt to elicit a response from the casualties. A couple are faking unconsciousness: we monitor their breathing, put them into the recovery position, and check for injuries.

Meanwhile, one of us pretends to phone for help. The emergency services number for most of Europe is 112; for Swiss mountain rescue, call 144. You will find the best number to use printed on your piste map; key it into your mobile as soon as you arrive in a resort.

Our trainer, Christine Gillespie – a ski patroller from Glencoe – tests us on different injuries. Have any of us skiers ever broken a bone, she asks? Alan Smith, a 51-year-old IT programme manager from Aberdeen, says he has broken his arm: a double fracture of the humerus. Particularly painful was the way the nurses at the hospital came in for a giggle at the patient in leopard skin leggings and a Rod Stewart wig: he had fallen down some steps at a fancy-dress party.

Christine talks us through different bone fractures, and we have to figure out how to deal with each one. She talks us through the essential first-aid kit we should carry as instructors, and shows us how to secure broken arms and dislocated shoulders using a triangular bandage. “But you’ll find if it’s any windier than this,” says Christine, “these things turn into weapons of mass destruction.”

Warning sign at the start of the Gentianes-Tortin itinerary, VerbierIt soon becomes obvious that administering first aid is even more challenging than usual when you are lumbering around in ski boots in deep snow on a steep slope – trying to monitor casualties’ breathing and checking them for injuries when they are wearing umpteen layers of puffy clothing.

Which is a good reason for all skiers to take a first-aid course such as this one, held by the British Association of Ski Patrollers (BASP). The skills we learn, though, are not confined to the pistes – as pointed out by one of the other trainers, Chris, a mountain rescuer from Ullapool. “Scotland has the highest rate of heart attacks in the entire developed world – you’re just as likely to see someone collapsing from a heart attack during après-ski.”

Our weekend course begins with a day of lectures and training indoors, led by Chris, Christine, Willie – another mountain rescuer from Scotland – and Andy, a helicopter-based paramedic working in the Lake District. We learn how to deal with medical emergencies that are a result of existing conditions – from angina and asthma to diabetes and epilepsy. We learn what action to take in the case of a heart attack, a stroke or anaphylactic shock. We practise giving CPR (cardiopulmonary resuscitation) to plastic dummies, and putting unconscious casualties into the recovery position.

It is a lot to take in. “But if you only remember one thing from this course,” says Chris, “it’s this: do not leave an unconscious person on their back. They could die.”

But practising these techniques on a carpet in a warm room is a far cry from carrying them out on a cold, blustery, snow-covered mountainside, as we discover with Christine the next day. Even checking for signs of life can be all but impossible. In conditions such as these, core temperature can only reliably be measured with a rectal thermometer (“no, I don’t carry one,” says Christine), while measuring a patient’s weak pulse can be tricky, especially when your own pulse is racing. “With all the adrenalin going around my own body, I’d get a pulse of 120 off my skis,” says Christine. Which is why the most reliable sign of life in an unconscious casualty is their breathing – and we spend a lot of time practising monitoring this.

Christine Gillespie, ski patroller from Glencoe, gives a first-aid course in VerbierHowever, you would rarely come across an unconscious casualty, says Christine. In her work as ski patroller at Glencoe she has to deal with “lots of knees and shoulders”, as well as broken bones, suspected spine injuries, dislocations (commonest are shoulders, along with the odd thumb and kneecap), ligament tears, and bumped bottoms – perhaps with a chipped pelvis or coccyx.

The nature of injuries will also depend on conditions on the mountain. Skiing in Scotland, says Christine, “you get very good at ice, bad weather and hard pack.” In fact her first experience of skiing outside Scotland was when she came to work a season in Verbier 12 years ago. “My first two weeks here I was in culture shock, thinking: my God, what’s all this snow? And with the powder, I just didn’t have a clue – I was totally lost, and just swam around in it.”

For us on the course, that powder is one of the reasons we are here. We may now have only a tiny fraction of the expertise of Christine and her colleagues; but it’s reassuring to know that if we do witness an accident on the mountain, we have some idea of what to do in those vital few minutes before professional help arrives.