Ski resort clinics keep people out of hospital ER


By Kathryn Reed

TWIN BRIDGES – An X-ray of a wrist is on the light board. The patient is being seen in one of the three exam rooms. Out front all of his vitals are inserted into a computer.

But this is no ordinary emergency room. This is where injured skiers and snowboarders come to be treated at Sierra-at-Tahoe.

It is one of three clinics Barton Health medical personnel operate. The others are at Heavenly and Kirkwood mountain resorts. They are staffed with an emergency room doctor, registered nurse, technician and radiologic technician.

Dr. Steve Leman considers Sierra the model ski clinic based on how it is set up and operates. Barton’s team works closely with Sierra’s ski patrol. Patrollers assist people with less serious injuries in the front area. They do more first aid work as trained emergency medical technicians.

Steve Leman is the doctor on duty Jan. 6 at Sierra-at-Tahoe’s medical clinic. Photos/Kathryn Reed

The three exam rooms Barton uses once were the ski patrol locker rooms. Dispatch is still there so everybody is hearing the same calls.

However, it is a patroller who decides when CalStar is called in to airlift someone off the mountain. Pilots have three locations they may land at Sierra. On Sunday a chopper is called to take someone out who has a head injury.

But Leman and his crew also treat head injuries.

“If we can stabilize them, they can go by private car to the hospital for a CAT scan,” Leman explained during a tour of the clinic Jan. 6.

He said there used to be so many head injuries with all of them taken by ambulance to Barton Memorial Hospital. This would present a problem for the rest of the community because the ambulances were tied up going to ski resorts – sometimes stuck in long holiday or weekend traffic – and unable to respond to other calls.

Leman said the medical clinics at the ski resorts mean fewer people going to the hospital’s emergency room.

With the 10 to 20 patients each clinic sees a day on peak weekends and Barton’s ER full at those times, “we would be in disaster mode,” Leman told Lake Tahoe News, if the skiers ended up at the hospital. That is why it’s imperative to have the clinics at the resorts, he added.

Barton staff was at Sierra all through the holiday period, while normally they are at the clinic just on weekends.

Sierra ski patrol operate the first aid clinic adjacent to Barton’s operation.

Even though skier visits are up 900 percent compared to a year ago at this time for Sierra, the number of injuries has not increased anywhere near that percentage. The soft snow is the big contributing factor to keeping people out of the clinic.

But their info is easily accessible. All of their data is entered into a computer that is part of Barton’s system, so it’s all centralized.

Plus, people can leave with their X-rays to take to their physician.

Leman, who used to be on the ski patrol at Sierra in the 1970s, said there was a time when someone would come up via bus, hurt themselves, be hospitalized and then need their parents or someone to drive to Tahoe to get them. With the clinic, pain meds are available to make the ride back tolerable, docs can stabilize many injuries, and they have the X-rays to know if someone needs more immediate care. This can mean the person travels back with their buddies instead of needing someone to come get them.

“They like me. I’m the lady with narcotics,” Sandy Wirth, registered nurse, says. She shakes her head though; wishing snowboarders would wear wrist guards.

CalStar flies into Sierra on Jan. 6.

Wrists and shoulders are what snowboarders injure most, while it’s knees for skiers. And the harder the snow, the more injuries there are. However, fresh, deep powder can increase knee injuries.

It’s cheaper if people go to one of the clinics at a ski resort because the charges are nowhere near the hospital’s ER costs. Plus, it’s faster.

“We are able to serve most patients at the resort and in most cases deliver definitive care, which saves them a long, painful drive to the hospital,” Warren Wither, medical director of emergency service at Barton Memorial Hospital, said. “The cost is lower for patients than at the hospital.”

It’s not just skier injuries the Barton crew treats.

“They help us with seeing employees with colds or flu,” John Rice, Sierra’s general manager tells Lake Tahoe News. “A lot of kids are away from home. They can come in and get a script.”

Wirth says she’s seen skiers who have had an allergic reaction, needed sutures and have let their sugar levels get too low if they are diabetic. While it’s considered a clinic for skiers and snowboarders, it is a medical clinic for anyone who needs it.





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