Introduction: Ambulances can't get up mountains, and air ambulances can't land on steep ground. However, UK ambulance assets are sometimes tasked to inaccessible locations that require a Search & Rescue (SAR) response, e.g. Mountain Rescue Teams (MRT) or hoist-equipped helicopter . We wished to ascertain: (1) The proportion of mountain users aware of correct procedure to call for help in event of a medical emergency in a location inaccessible by road (999>Police>request MRT), and (2) the proportion of UK ambulance services with formal policies for handling such calls.
Method: 256 mountain users (walkers, mountain bikers, climbers) were surveyed at four mountain locations in Wales (in Snowdonia and the Brecon Beacons) using a structured bilingual (English/Welsh) questionnaire. A phone survey of all UK mainland ambulance services was conducted by an EMS controller. Replies were received from 13 from the 14 UK mainland ambulance services.
Results: Only 12/256 (5%) of mountain users knew the correct procedure to summon help. The correct procedure is to call Police, who will then notify Mountain Rescue. 61% of users indicated that they would have first asked for "ambulance." 8% of users would "tell the operator what happened," 26% would attempt to contact Mountain Rescue directly, and 12% would ask for an ambulance, then Mountain Rescue. Only two UK ambulance services (of the 13 we questioned) have implemented a definite formal pathway for handling calls requiring an SAR asset, although a third was developing one and some regional control rooms had significant local expertise.
Conclusion: 95% of mountain users in this survey (conducted in Wales, but likely representative of the UK) do not know how to summon help in an emergency in the hills. The majority would ask for an ambulance, unaware that only the police can task MRTs. Furthermore, most ambulance services have no formal procedure to streamline the handling of calls requiring SAR assets. This may lead to disaster: delays calling for SAR assistance when required can cost lives. A system solution, built into ambulance dispatching software, is urgently required to ensure that ambulance calls requiring SAR response are identified and appropriate assets tasked at the earliest opportunity. We have approached the International Academies of Emergency Dispatch and suggested that this problem be addressed within their MPDS dispatching system, which is used in many UK ambulance control rooms.