Julie Rust has to ride a couple of chair lifts and then ski the peaks of the Arapaho National Forest to reach her office. When she gets there, she places her skis upright in a metal rack and is greeted by Henry, a golden retriever and the unofficial mascot of the ski patrol at Vail Resort in Colorado.

“He's the best medicine for injured skiers on the mountain,” says Rust as she removes a glove and pats Henry on the head. “He brightens everyone's day.”

Rust is the director of Vail Ski Patrol and has worked on Vail Mountain (elevation 11,570 feet) for 28 years. Her team patrols the resort's 5289 acres in the Arapaho National Forest, which stretches across 1.73 million acres of the Rocky Mountains. Her team's main responsibility is to ensure injured people are found, stabilized and skied down the mountain — usually via toboggan — to an awaiting ambulance.

She said calls about injured skiers and snowboarders come in from wireline telephones, often found at ski-run intersections. If an emergency does occur, calls are received by dispatchers located at ski patrol headquarters, and then data are transmitted to the Eagle County public-safety answering point, or PSAP, headquartered in Vail.

Often, 911 calls from cell phones are routed directly to the PSAP, which then transmits incident data to ski patrol dispatchers, Rust said. When a call is received, the ski patrol records the call and sends a team to the coordinates to assess any injuries. Ski patrol personnel carry two-way radios that operate on a 400 MHz UHF system, Rust said. They have access to 14 primary communications channels but only use three, including a channel designated for medical emergencies only.

To ensure everyone's on the same page, the team uses codes sparingly. “We mostly use plain-speak, especially since paramedics have moved that way,” Rust said.

Depending on the injury, paramedics are contacted through the ski patrol directly or through the Eagle County PSAP, which serves more than just the resort. It is responsible for 800 square miles and handles calls and incidents for 12 different agencies spread across the county. As a result, dispatchers often handle more than 400 calls per shift, said Joe Ribeiro, the PSAP's director of emergency communications. To ensure consistency, the center uses the National Academy of Emergency Dispatcher's protocols — a set of questions for dispatchers to ask callers.

“That questioning helps us determine what the problem is, to get the right resources to the person and then to dispatch instructions if needed,” Ribeiro said.

The center operates an 800 MHz system that consists of 12 tower sites that are connected by T-1 lines and microwave links to the PSAP's communications center. Dispatchers use an InterGraph CAD map-based software system to record captured data.

Location information often is among that data. If a 911 call is made from a Phase II, GPS-enabled cell phone, dispatchers can identify the caller's latitude and longitude and pass along that data to the ski patrol. However, interoperability is another matter, as the two agencies cannot talk radio-to-radio because the ski patrol runs a UHF system while the PSAP operates on 800 MHz frequencies.

“Because they are disparate systems, we would need to set up a full-time patch, and that requires infrastructure and technology,” Ribeiro said. “It's definitely doable but something to approach carefully. One thing might be to consider [the PSAP] dispatching ski patrol — but that's one of those things where you have to be careful what you wish for.”

Skiers often leave the resort area and ski out of bounds into the Arapaho National Forest. When that happens, the PSAP works with a separate agency, Vail Mountain Rescue, on search-and-rescue missions.

“The rescue [squad] has radios that work on our system, and that's when we would patch them together or go out to the command post and issue radios that work on our system to rescuers,” Ribeiro said.

If an injury happens on Vail Mountain, the call eventually is routed to a team of paramedics at the Eagle County Ambulance District. Fred Morrison, general manager of the ambulance company, said that most often the PSAP will contact the ambulance directly with a designated patient pickup point, “of which we have several around the various mountains,” he said.

The ambulance district also runs on an 800 MHz system, so it has communications with all of the surrounding first-responder agencies: dispatch, fire, police and EMS. As Rust indicated, paramedics use plain-speak language to communicate and often turn to cell phones to contact the ski patrol when they don't want data broadcast over the air, Morrison said.

It would be better if the ski patrol were more integrated, he said, but that would require installing another radio in each ambulance. According to Morrison, there already is enough technology for paramedics to manage.

“It's hard to manage all the technology, especially if you have one paramedic in the back taking care of the patient and the other trying to drive and manage all the technology — it can get distracting, and we don't need that at all,” he said. “The best thing that happens is that we meet [the] ski patrol face to face during hand-off, and we have an intimate discussion on the patient's condition straight from the horse's mouth.”

The ambulance company recently added mobile-data terminals to its vehicles. Eagle County PSAP now can send digital data updates to first responders headed to the scene, Morrison said.

“We are still getting our hands around it,” he said. “But it's working OK.”

However, the data doesn't transmit into the receiving hospital's electronic medical record (EMR) system, said Jeff Micheelis, IT manager for the Vail Valley Medical Center. Though the hospital has installed 802.11 b/a/g wireless networks, data are entered into the hospital's EMR when the patient enters the emergency room, not before.

“There's a lot of patient privacy issues,” Micheelis explained.

However, once data are entered, medical staff can access it wirelessly using mobile computers that can be wheeled throughout the hospital, he said. But Micheelis doesn't foresee extending this capability for the next couple of years.

While Micheelis contemplates the future, Rust always is thinking about the next day. She only can estimate how much snow will fall on the mountain and how much wind will gust through its peaks. She checks every weather source, including forecasts from the Colorado Avalanche Information Center, to help determine staffing needs, but the reality is that each day is unpredictable. Skiers' injuries will vary depending on conditions, as well as their attitudes and abilities. Despite this — or maybe because of it — failure is not an option.

“Everything happens, a twisted knee or worse … or simple hyperventilation because of the altitude and being uncomfortable in this environment — like I would be in New York City,” she said. “Our job is to get them down the mountain safely no matter what. It's that simple.”