It's 8 a.m. and Peter Brandes is sitting behind his desk at the Eagle County Ambulance District in Vail, Colo., assessing the weather. It is 30° F and foggy in Colorado's Arapaho National Forest, and forecasters predict at least a foot of sleet and snow. He says he needs to keep a close eye on the weather “because it's an accurate picture of how my day is going to go.”

Brandes moved to Colorado to become a ski bum 25 years ago. After a friend was paralyzed in a car accident, he became interested in pre-hospital care and trained as an EMT and then a paramedic. Now, he oversees 50 full- and part-time employees as operations manager at the district. The district services communities within approximately 800 square miles of rugged, mountainous terrain, he said.

Paramedics carry 800 MHz two-way radios and personal cell phones to communicate. The district is working to convert to the state's Project 25 system, he said. But he admits that because of the geographical area, coverage is difficult.

“We still have spots with no coverage,” he said. “But we know where they are.”

When push comes to shove, his team turns to GlobalStar satellite phones. There is one in each vehicle, and search-and-rescue personnel carry them because they often are in the back-country and “more off the grid than we are,” Brandes said.

Reliable radio communications are essential. For example, the district covers Vail Pass, a harsh and dangerous environment for the crews. A bad weather day can cut off the ambulance company's route to the mountain ski resorts and access to hospitals. Brandes said road closures due to heavy snowfall or avalanches can close Interstate 70, the only highway in and out of Vail.

“That highway is our lifeline,” Brandes said. “If there are road closures due to accidents, snow slides, avalanche control — we're in a world of hurt. We had an accident last winter that was a mile long, with about 50 to 60 cars. We were working it with multiple agencies coming from two different sides of the highway because when I-70 and Vail Pass is plugged up by an accident, we can't get anybody there. Communications became essential at that point.”

A helipad station is available during daylight hours 30 miles to the east in Frisco, Colo. Helicopters can be used when weather permits, but often varying mountain conditions restrict visibility. As a result, even administrators on staff keep up to date on paramedic certifications to address incidents, Brandes said.

“We are a small enough organization that if things hit the fan, I would be in uniform working,” he said.

After 25 years of tending to the dead, the dying and the distressed, Brandes has reached a calm equilibrium where it all has become routine. That's a far cry from earlier in his career when he worked in a neighboring community as a volunteer EMT. He lived in a small community with a population of 600.

“Everyone knew each other,” Brandes said. “And every call I went on I knew the victim. That's tough to do.”

Mary Rose Roberts is the associate editor for Urgent Communications.