The Regional Mountain Trauma System (RMTS) is a pioneering initiative founded by Dr. Mark Kryskow and his partners to improve trauma outcomes in alpine and remote environments. RMTS brings together mountain first responders, evacuation teams, and trauma centers into a coordinated, learning-based system—ensuring patients receive the right care, at the right time, regardless of terrain or distance.
Mission
To enhance the efficiency, coordination, and outcomes of trauma care in mountainous and remote regions—where response time, technical expertise, and environmental conditions demand an integrated approach.
Vision
A fully connected mountain trauma network delivering seamless, high-level care from point of injury to definitive treatment, while continuously learning and improving through shared data and education.
Why RMTS Exists
In mountain regions, every minute matters. Yet injured patients often face prolonged transport, they may be under-triaged, or arrive at facilities that are unequipped to manage complex trauma. At the same time, ski patrols and mountain responders frequently never learn what happened to the patients they treated, or whether their interventions changed outcomes.
RMTS was created to close these gaps while improving coordination, enhancing decision-making, and ensuring that geography never determines survival or recovery.
How RMTS Works
RMTS operates as a collaborative, systems-based model that links teams across disciplines and geography, combining real-time coordination with structured feedback and education.
Core System Components
Integrated Communication
Real-time coordination between ski and mountain patrols, EMS, air and ground transport, and trauma teams to support rapid triage and informed decision-making.
Coordinated Transport Pathways
Patients are directed to the appropriate level of care from the outset—reducing delays, unnecessary transfers, and preventable complications.
Standardized Handoffs
RMTS-designed patient handoff tools ensure critical information moves accurately from the mountain to the trauma center.
Education & Case Review
Monthly multidisciplinary case reviews provide feedback to mountain responders and hospital teams, closing the loop between field care and outcomes.
A Learning System, Not Just a Network
RMTS is built on continuous improvement.
- Home to the world’s largest prospectively collected ski, snowboard, and mountain bike injury database
- Uses a custom-built trauma dashboard to track interventions, triage accuracy, outcomes, and opportunities for improvement
- Selects 2–3 cases monthly for deep-dive review and education
- Actively contributing to updates of the Outdoor Emergency Care (OEC) manual and multiple research initiatives
RMTS is committed to team review of a real high impact incidents, asking not only what happened, but how to improve next time.
Effective mountain trauma care depends on systems. When patrollers, paramedics, flight crews, and trauma teams share information and understand each other’s realities, outcomes improve. Patients get better care, EMS and ski patrol teams have greater insight to injury patterns, and trauma centers have the ability to track data.
Innovation: From Combat to Clinic
RMTS draws on military-informed trauma system design, translating battlefield-tested principles into civilian mountain environments. Dr. Kryskow’s experience in military medicine, alpine rescue, and trauma leadership informs a model built for speed, adaptability, and precision.
Training & Outreach
RMTS actively supports local ski resorts and bike parks by providing:
- In-person medical refreshers for patrol teams
- Hands-on training in mountain trauma response
- Ongoing education aligned with real-world injury patterns
The Road Ahead
The vision of RMTS remains focused on building a replicable model of integrated mountain medicine. RMTS is rapidly expanding beyond its original footprint. Over the next five years, the system is expected to grow across additional resort regions, with active expansion underway in New Hampshire, Vermont, and New York, and emerging partnerships with bike parks in other regions.
GET INVOLVED
RMTS welcomes collaboration. Individuals and organizations can engage through clinical participation, education, research, or operational support. Those interested in contributing, professionally or financially, are encouraged to reach out directly to RMTS leadership to explore current initiatives and opportunities. Visit the link below!