Please read all course information thoroughly and early. 
Your preparation is the most important factor in course outcomes! 

Course Description
The WMS DiMM Alpine Skills and Rescue session of the Diploma in Mountain Medicine is taught by Remote Rescue Training, a division of the Center for Emergency Programs at the University of Utah. The snow- and ice- covered slopes of Mount Rainier will be our classroom.  The course is designed specifically for medical professionals pursuing the WMS Diploma in Mountain Medicine. The unique challenges for mountain rescuers responding in glaciated and snow-covered terrain will be thoroughly covered during our intensive, field-based curriculum. This course emphasizes individual skills, team rescue and the role of medical personnel in mountain rescue: directing patient care, assisting in technical rescue, and leading the integration of both into one coordinated effort. The skills mastered during this course can easily be transferred to similar environments the world over.  While we will review mountain travel techniques, candidates should have previous technical glacier travel and snow camping experience.

Tentative Course Schedule (Subject to Change)

Day Activity
Day 1- Meet at the Riverfront Cabin in Packwood, WA at 6PM. Group dinner, introductions, logistics, daily training gear overview. 
Day 2- Snow travel, crampon and ice axe use, self-arrest, glissade, roped team travel. Tent/stove set-up and use. Upper mountain gear overview. Pack to go to Muir.
Day 3- Travel to Camp Muir. Glaciology, glacier camp craft, Leave No Trace, anatomy of a rescue/case studies.
Day 4-   Litter systems and patient packaging, snow anchors, lowering/raising systems.
Day 5- Rope team travel in complex glaciated terrain, crevasse rescue, managing mountain hazards.
Day 6- Mountain exploration and patient access, stabilization and transportation.
Day 7- SAR scenario. Descend from Camp Muir by mid-afternoon. Sleep at Nisqually Lodge, dinner in town. Course ends late evening, after dinner. 

COVID 
This course will follow the current WMS DiMM COVID-19 Safety Guidelines and Standard Operating Procedures. Protocols may be updated to adapt to the state of the pandemic at the time of the course or to meet updated local regulations. This may include changing logistics or even cancelling the course. Updates will be approved by the WMS Board and WMS DiMM Leadership Committee and passed on to participants as soon as practical. At this point our expectation is to be able to run this course as described in this document. Current guidelines include: 

o All participants agree to pay extra attention and effort to good hygiene and minimize possible exposure to communicable illness immediately prior to the course, including physical distancing and masking as much as practical during travel to the course.
o Participants should not arrive at the beginning of the course with any signs or symptoms of COVID or flu like illness (fever, cough, shortness of breath, runny nose, sore throat, chills, body aches, fatigue, headache, loss of taste/smell, eye drainage, congestion, vomiting or diarrhea), even with a negative COVID test. Any of the above signs/symptoms may require the individual to leave the program at their expense (cost of motel, subsequent care, and transportation home are participant’s responsibility).
o All participants agree to pay extra attention and effort to maintain good hygiene practices throughout the course. Good faith efforts to protect ourselves, our peers and our community from communicable illness are especially critical during this time.
o Participants will be in close proximity to one another and the instructors during the course. Physical distancing will not be possible within course. Physical contact during the course is inevitable and inherent to the experience.
o Communicable illnesses including COVID-19, other respiratory illness, gastrointestinal illness or other life-threatening illness may be contracted during the course due to the close proximity of learning space and living quarters.

Altitude
All participants must be familiar with the WMS Clinical Practice Guidelines for the Prevention and Treatment of Acute Altitude Illness (https://pubmed.ncbi.nlm.nih.gov/31248818/ or https://www.wemjournal.org/article/S1080-6032(19)30090-0/fulltext). The DiMM Alpine Skills and Rescue seminar will spend the first two nights at ~1000’ in Packwood. Our first training day we will drive up to Paradise at 5,400’ and then walk up to ~7,500’ for the day. On day 2 we will drive to Paradise again and then walk up to Camp Muir at 10,000’ where we will spend 4 nights and venture higher on the mountain during the following days. This is not an ideal acclimatization schedule. All participants are required to determine their risk profile (e.g., history of altitude illness and home elevation), develop an altitude illness prevention plan and share these with instructors in the pre-course questionnaire. High risk individuals coming from low elevations are recommended to preacclimatize prior to meeting the group in Packwood: come early and day hike up on the mountain or find another location to do the same immediately prior to the course. All participants are required to bring altitude medication for their own use, as needed for prevention and/or treatment: we recommend acetazolamide 10 x 250 mg. We also recommend participants consider bringing dexamethasone (12 x 4 mg oral) and nifedipine (8 x 30 mg extended release version) based on risk profile and medical history. Participants need to arrange a phone, virtual or in-person visit with their PCP well ahead of time to receive these prescription medications. Any signs or symptoms of altitude illness must be reviewed daily with the instructor team. 

Ground Transportation, Travel Logistics, & Lodging
The course starts in Packwood, WA, and ends in Ashford, WA. Participants need to arrange for all transportation to meet at the Riverfront Cabin: 156 Slalom Way, Packwood, WA. Please plan to arrive by 5PM on Day 1. We will need vehicles to get around and we encourage carpooling. Unless you opt out, Anna will share your contact information with other participants so that you can arrange to carpool. On Day 7, after we descend from Paradise, we will drive to Ashford for dinner, course wrap up and a night at the Nisqually Lodge. Cell phone coverage, including in Ashford and at Camp Muir are spotty at best. While up at Camp Muir we can leave cars in the trailhead parking lot, where historically they have been secure. The course ends late in the evening on Day 7. Two nights lodging in Packwood and one night in Ashford are included in your tuition. Plan to stay at the lodging in Packwood with the course and we encourage you to stay the final night in Ashford. Rooms are double occupancy with two beds. Mixed gender occupancy may be required. 

Food
The DiMM Alpine Skills and Rescue seminar will spend a total of three nights in town, and four nights camping on the flanks of Mount Rainier. While in town, dinners are included in your tuition, but you must provide your own lunches and breakfasts. For these breakfasts and lunches (Saturday, Sunday and Friday) we will be based in town so it shouldn’t be hard to get a quick breakfast and lunch to go, or you can bring something to make at the AirBnB. For the time we are camping, you will need to have pre-planned, purchased and packed food prior to your arrival in Packwood.

Countless options exist for menu planning on extended trips into the wilderness.  While camping, participants are responsible to bring and cook their own meals for 4 full days (4 breakfasts, 4 dinners and 5 lunches; plus 1 lunch for the skills day on Saturday).  This aspect of mountaineering is as important, in terms of self-sufficiency, as the technical skills taught.

The options for meals differ depending on the amount of time and effort that you have to spend preparing before and cooking while on the trip.  We have developed a sample plan below that minimizes the preparation in all aforementioned categories.  

This wilderness rescue and climbing expedition may require a higher energy expenditure on a daily basis than what you may be used to. Eating well and frequently not only sustains energy levels but also keeps positive morale and attitude. We will likely experience periods of inclement weather and it is important that caloric intake is adequate and regular to maintain energy and avoid injuries.  

Your menu should consist of a well-balanced selection of food groups. It is best to plan most meals with high levels of complex carbohydrates to provide the most efficient long-term energy production. Refined sugars, or simple carbohydrates, such as in candy, provide quick, short-term energy. Proteins are necessary for good health, but not in the quantities that most people usually eat. On a four-day trip it is not critical if protein levels are slightly deficient. Fats require more oxygen and time to metabolize; this can be an important consideration when planning your meals.  

Meals should consist of light, compact foods. That usually means a high percentage of dried items, pastas, grains, etc. to minimize weight and bulk. Packaging should be minimal, but good organization and protecting food from weather and your backpack are also important factors. A single burner camp stove and pot (MSR Wind Burner Duo or similar, provided by Remote Rescue Training) will be the only cooking hardware- no pans. A well-planned menu should amount to roughly two to two-and-a-half pounds per person per day, packed weight. A far as quantity goes, your objective should be to eat everything you carry up there, be full and have no extra food at all when we head back down the mountain.
 
Staying hydrated while climbing is very important; you may want to consider bringing mixes to add into drinking water to encourage drinking. 

There is refrigeration available at our lodging in Packwood if you plan to bring perishables such as cheese.

We will not have time to go food shopping in Packwood once the course starts. Food planning, shopping and packing for 4 breakfasts, 4 dinners and 5 lunches must be completed prior to your arrival in Packwood, WA.

BREAKFAST- Breakfasts should consist primarily of either quick-cooking hot cereals or hearty cold cereals.  These choices should contain lots of calories and carbohydrates and not something that is mostly sugar.  Most hot cereals are better when fortified with something like raisins or other dried fruit, in addition to sugar or honey and powdered milk.  The following examples suggest quantities for one person for one breakfast (approximately 300-600 calories/breakfast):  
 
Option 1  
1-2 cups Grape Nuts or Muesli or other cereal 
3 tablespoons powdered milk  

Option 2 
1/4-1/2 cup instant cream of wheat  
3 tablespoons powdered milk  
Option 3  
2-3 pkg. instant oatmeal or cream of wheat  
3 tablespoons powdered milk  

Option 4                                                         
2-4 strips pre-cooked bacon 
1 breakfast bar or half a bagel  

HOT DRINKS- Hot drinks are a fundamental part of breakfast and dinner. Hydration is a key element to climbing, and hot drinks help people hydrate. It is a good idea to repackage drink mixes in Ziploc bags to save on the amount of trash. Some ideas include: hot chocolate, hot lemonade, instant coffee, spiced cider, tea, miso soup and warm powdered milk with brown sugar. We recommend 1-2 hot drinks per breakfast and 1-2 more hot drinks per dinner.

LUNCHES- Lunches begin just after breakfast and end just before dinner. It is the most important meal of the day and should have enough variety to keep you eating. To combat possible diminished appetite at altitude, bring your favorite snacks.  Continuous, and on the go, eating of small quantities keeps up energy levels all day. Examples are outlined below, though items and quantity may be substituted based on food preference and appetite. The following examples are for one person for one lunch (approx. 800-1200 calories/lunch): 

Option 1 (best for day 1 of camping) 
Pizza/sandwich 
Bagel with meat & cheese 
Candy bar 
Piece of fresh fruit 
Drink mix for your water 
 
Option 2 
4 Energy bars or gels
Candy bar 
Drink mix for your water 
¾ oz. package of Corn nuts 
1 oz. beef jerky 

Option 3
Bagel with meat & cheese 
Candy bar 
4-6 fig or other cookies
¼ cup mixed nuts 
Drink mix for your water 

Option 4  
3-6 hearty crackers (Pilot bread) with meat & cheese 
2 energy bars or candy bars 
¼ cup dried fruit 
¼ cup mixed nuts
Drink mix for your water 
 
*Ideas for substitutions depending on your food preference: jerky (beef, turkey), energy bar, corn nuts, large cookies, candy bars, granola bars, crackers, bagel, string cheese, mixed dried fruit, hard candy, drink mix (electrolytes), and energy gels. 

DINNERS- By far, the easiest option for dinners on this trip are freeze-dried food.  These meals typically only require boiling water to be added, and can be eaten within minutes. Often the packaging serves as both heating container and the serving bowl. Some people find that a complete dinner of freeze-dried food for one person requires a package with “2 servings.” Improve freeze dried meals by supplementing with nuts, beef jerky, etc. There are many newer companies making freeze-dried meals that tailor to modern diets and palates. Another simple way to go that is delicious but a bit heavier are the Indian meals in a pouch such as made by Tasty Bites or Saffron Road.  

Another option that cooks in slightly more time includes items such as Knorr rice or pasta entrees in envelopes.  It is imperative that you experiment ahead of time in the comforts of home.  For those that wish to cook from scratch, we have included the following sample recipes, which are for one person for one dinner (approximately 800-1200 calories/dinner): 
 
Option 1  
-1/3 cup of instant mashed potato mix added to soup mix, and a little butter, ¼ cup shredded beef or turkey jerky (or substitute cheese), spice to taste
- Soup or ramen noodles

Option 2  
-1 cup dry pasta cooked (elbow macaroni cooks fast and is space efficient in backpack) 1 small bag tuna/chicken added when done (oil packed has more calories), 1 envelope of a powdered sauce mix, and a little butter  
- Soup or ramen noodles 
Option 3  
-Casserole: 1/4 cup pasta, 1/4 cup instant or quick cooking rice, 2 oz. diced Summer sausage or ¼ cup shredded beef or turkey jerky, powdered garlic, dehydrated onion, 1 package powdered sauce mix, cheese melted over the top 
-Soup or ramen noodles 

Option 4  
-1 packaged rice/pasta dinner (substitute powdered milk for real milk, butter will keep.) 
-Soup or ramen noodles 
 
Spend some time tasting and planning your meals.  In the challenging mountain environment, rescuers must first know how to care for themselves! Only then are we capable of assisting others in need.  

Gear
The following is a list of items that will be required for participation during this training.  Please spend time looking through your gear early. Some items may not be available in your local stores.  Allow time to return items, especially if purchasing on the internet.  All items will work best if the user has experience using them- for instance pack your pack and wear your clothes on a training hike in bad weather to see how your boots fit, if your pack needs adjusting, and how your clothing layering system works; make sure your sock system and crampons work with your boots.

Specific examples of the required gear are provided.  These are only examples.  Please compare things on this list with what you have or what you are buying.  There are hundreds of options out there.  You do not need to go buy all new gear for this training.  Feel free to borrow or rent from a friend or local retailer anything that you do not already own, previous DiMM students may be a great resource.  If it is time for an upgrade, then purchase gear that will last. We just want to make sure everyone has the gear that will function properly in the hostile mountain environment we will be operating in.  

We will carry all this gear plus group and rescue equipment, so think lightweight, compact, functional and durable.  There will not be time during the course to go to a gear shop for last minute items- make sure you show up with everything you need for the course. Start to gather your equipment early. Anyone not properly equipped may not be allowed to participate in course activities.  Things we often see problems with are boots, pack, crampon fit, and acquiring a VT prusik.
 
Glacier Travel/Rescue Gear:
Large Backpack- 60-80 liters (4000 to 5000 cubic inches). With careful planning and packing, and a focus on compact lightweight gear, a 60-liter pack may be sufficient. Some folks will enjoy having the space of a larger pack. You will be carrying group gear such as ropes, a tent, etc. No matter the size of your pack you should make efforts to keep your personal gear small and light and bring a couple lightweight cords or straps so you have the option to strap items on the outside. There should be a way to attach your ice axe to the outside of your pack. Exped Backcountry 65, Acr’teryx Bora AR 65 or Osprey Xenith 75. Go to a shop, have them load it with weight, and walk around.  Everybody’s back is different.  Go for what fits you best. We will use this pack when we move up to Camp Muir and for day trips on the upper mountain.

Mountain Axe- Straight shaft that can be plunged in snow, with adze. Petzl Summit.

Ice Axe Leash- Some folks prefer a waist attachment over a wrist leash. Black Diamond Slinger. You can also use a Purcell Prusik for this purpose.

Climbing Harness- Some people prefer to have a more padded for comfort during crevasse rescue practice. But we will spend more time wearing the harness under a pack, and will likely often have layers under the harness, so some folks prefer a lighter, low-profile harness. Your harness should have gear loops and a belay loop. Mammut Zephir Altitude.

Crampons- Make sure they are compatible with your boots (there are different styles of attachment) and stainless steel. No aluminum crampons. If you have old crampons with a rigid or vertically oriented frame, it is time to update. Anti-balling plates (often integrated into crampons) are highly recommended. Some method to carry your crampons on or in your pack is also recommended- a light case or point covers. Black Diamond Sabretooth. 

Helmet- Must be designed for climbing. Black Diamond Capitan or Vision. (If you get a lightweight foam helmet like the Vision, be careful packing it for travel as these are not designed for side impacts- I usually put mine in my carry-on, rather than check it in my luggage, during plane travel.)

Snow Picket- MSR Cable Picket, 2 foot. If you bring one that does not have a cable permanently attached, you should also bring a sewn 120cm sling for your picket.

Ice Screw- Petzl Laser Speed, 17cm.

Nylon Accessory Cord (6mm x 7m)- Any climbing store will have this. Brand is no big deal, but supple cord is nice. This will need to be cut in three pieces to make a Purcell Prusik and two prusik loops. The exact lengths don’t matter for our purposes.  Cut and tie your cords before the course! (See Pre-Course Skills Preparation section below.) 
The correct lengths for your three pieces of 6mm cord:
Purcell Prusik: ~4 meters
2 Short loops: ~1.3 meters each

Belay Device- Tube style belay device. Black Diamond ATC-Guide.

VT Prusiks (optional, but recommended)- - Two BlueWater Ropes VT Prusik. You will not find this in local stores. Buy it on-line from the manufacturer. This specific product replaces tandem prusiks for belaying a rescue load. Both the 7mm and 8mm options will work fine. This Technora open-end prusik is only made by BlueWater.

Anchor Building Material- Some people like a cordelette (15-21’ of 7mm nylon cord; cheaper and more versatile) while others prefer a skinny sewn sling (180 or 240 cm x 8-12mm; Mammut Dyneema Contact 240; lighter and stronger). Take your pick and we will discuss the differences.

Webbing for Pack Tether- A 120cm sewn sling (or 7’ of 1” tubular webbing). Mammut Dyneema.

Mini Pulley- Lightweight Prusik minding pulley. One is fine, some folks like two. Petzl Mini. Some people like the Petzl Micro Traxion which is fine as well.

Carabiners (6 non-lockers, 6 lockers)- Black Diamond Vapor Lock and LiteWire. Make sure to mark your carabiners with distinctive tape or nail polish to minimize gear confusion. 

Radio chest harness (optional)- One that can be comfortably worn under a pack, isn't too hot or bulky and works with your radio. Coaxsher RP-1 Scout, Conterra Adjusta Pro II. Probably won’t make the cut to bring up to Muir, so just bring it if you already own one.

Radio. An FRS/GMRS radio (aka family band or blister pack radio) is the easiest and cheapest solution- make sure your radio has sub-channel (often called “privacy code”) functionality. Know how to change channels, sub-channels, adjust volume, etc. An FRS/GMRS radio does not need programming, you only need to know how to use it. The nicest versions of these are the Rocky Talkie, with the Backcountry Access Link 2.0 coming in a close second. Another option is if you have a programmable VHF/UHF such as the Baofeng UV-5R or UV-82HP that could work too. We can help program these two specific radios, otherwise contact us for a frequency list and make sure you program your radio before the course starts. There is no place to charge batteries at Camp Muir.

Trekking Poles (optional)- Adjustable trekking poles w/ snow baskets.  Black Diamond Alpine Carbon Solo pole. Powder baskets are bigger and won’t sink in the snow.

Camping Gear:
Sleeping Bag (~0°F) w/Compression Stuff Sack- Expedition quality rated to ~0° F. Some people may be able to do with a bag rated to 15° F but we do not recommend bags lighter than that. Temperatures at Camp Muir are not likely to be less than 10° F. Down is much lighter and more compressible. Rab Neutrino 800. 

Sleeping Pad- 1 inflatable pad. Sea to Summit Ether Light XT Insulated or Big Agnes Q-Core SLX Insulated. Some folks like to bring a second half-length small lightweight closed cell foam pad for increased insulation, to sit on and in case the inflatable gets a hole. Z Lite Sol. We will be sleeping on snow at Camp Muir.

Water Bottles- Wide-mouth. Most people find that during the day 2-2.5 liter capacity is about right. Because we are melting snow having additional capacity can make cooking much easier. Insulated bottles like Hydroflasks keep water warmer but are heavy and bulky. Some folks like to use a 0.5 liter Nalgene which can easily be insulated in a parka pocket and double as a mug. CamelBaks/bladder systems can work if it’s warm, but if it’s cold, tubes and bite valves freeze easily. A lightweight water bag such as the MSR DromLite increases water storage capacity with minimal bulk.  My system: One 0.5L wide-mouth Nalgene bottle, two 2L DromLites.

Water Disinfection- We will snowmelt on the way to Muir. At Camp Muir we will collect snow to melt on our stove to make water. If we can find clean snow, then snow melt is generally a lower risk of contamination. We recommend you bring something to disinfect water. See: https://www.wemjournal.org/article/S1080-6032(19)30116-4/fulltext 

Headlamp- Lightweight with fresh batteries. Petzl Actik.

Food- See included documentation.

Pee Bottle (optional)- Anything that is not easily confused with your water bottle- a Gatorade bottle works great. The best pee bottle I’ve ever used is the Nalgene Wide Mouth Cantene (48 oz).

Pee Funnel (optional, for women)- Some women like to have this so you don’t need to pull pants down to pee (there is often minimal privacy on a glacier). Try to use it standing up, with your harness on. Really. For more info see: https://www.backpacker.com/gear-reviews/the-complete-guide-to-female-urination-devices/ 

Bandana (optional, for women)- Some women often like to have a bandana to use as a “pee rag.” 

Clothing:
FEET
Climbing Boots- Climbing Boots- Boots have come a long way. If your boots are old, consider a new pair. Camping and doing rescue work in the alpine requires warmer boots than for typical summer climbing. We recommend warm single boots. These could have a built-in gaiter such as the La Sportiva Aequilibrium Top GTX or Scarpa Phantom Tech. Warm single boots without a built-in super gaiter (such as the Boreal Arwa or Scarpa Mont Blanc Pro GTX) might be fine too, especially if you tend to not get cold feet. Double boots (with a removable boot liner such as the La Sportiva G2) are probably heavier/warmer than you would ideally like. A slightly stiffer- rather than softer- sole is preferred when spending time in crampons and kicking steps. Make sure you try them on and get them fit right. Make sure they are compatible with your boots. Spend enough time in your boots to know that you will not get blisters- go for hikes well before the course starts. (Note: you may have seen a pre-course video Alpine PPE that says that double boots are required- as we have changed course dates, other options are now preferred.)

Gaiters (optional)- Some boots have built-in gaiters. Otherwise something to keep the snow out is important. Some people have success with a simple elastic cuff on their pants.

Wool or Synthetic Socks- 6 pairs of comfortable, warm merino wool or synthetic socks. Make sure to fit your boots with your socks. Enough good socks to have a fresh pair every day can minimize blisters and other foot problems.

Liner Socks (optional)- Some people like these, while others find them an unnecessary annoyance.

Hiking shoes- Lightweight walking or running shoes can be very useful walking up the trail out of Paradise. Also, they are useful at Camp Muir, especially when the weather is good. Altra Escalante Racer. 

BODY LAYERS
There are many layering systems to achieve sufficient warmth, breathability and versatility. We recommend wearing lightweight long underwear top and soft shell pants and jacket (or wind jacket) as everyday wear.  In addition, rain jacket and pants are critical for stormy weather. Further insulation should be achieved with warm puffy layers (top and bottom) AND an additional light puffy jacket and/or mid- or expedition- weight layer (top and bottom). Weather can vary significantly on Rainier, but it’s likely to have some sun/warm and some cold, stormy and wet.

Rain Jacket w/hood- Breathable and waterproof.  Outdoor Research Foray or Arc’teryx Zeta SL

Rain Pants- Breathable and waterproof.  Zippers that allow you to pull shell pants on over/around boots are very helpful. Outdoor Research Foray or Arc’teryx Zeta SL

Soft Shell Jacket or Wind Jacket (optional)- Some folks swear by a wind or soft shell layer, others just use a rain jacket as an all-purpose shell. Black Diamond Alpine Start

Soft Shell Pants- Arc’teryx Gamma AR 

Base layers- Lightweight synthetic or wool long underwear top and bottom. We also recommend a lightweight short sleeve top and a pair of shorts. A sun hoody could be very useful in the right conditions. 

Mid Layers- 1-2 mid layering options. Lightweight puff, fleece, etc. You might travel wearing this. Patagonia Nano Puff.

Puffy Hoody Jacket- Rab Xenon 2.0 Hoody or Arc’teryx Atom AR Hoody.

Puffy Pants (optional)- Black Diamond Stance Pants. Depending on weather forecast, these might not make the cut.

HANDS:
A good hand layering system should be flexible enough to achieve the following 3 goals: 
1. Lightweight coverage for warm, sunny days with maximum dexterity.
2. Warm gloves for doing things in cold, windy and/or wet conditions.
3. Ultimate warmth when dexterity is a low priority.

As drying gloves can be difficult (at Muir and Paradise), extra gloves can be a huge help. 

Soft Shell Gloves- Two pairs. Black Diamond Terminator.

Work and Warm Gloves- Two pairs. Truck Gloves M1 and Arc’teryx Fission SV.

Mitts (optional)- Marmot Randonee. Like the puffy pants, these might not make the cut. Outdoor Research Mt Baker Shell.

HEAD:
Warm Hat- Wool or synthetic ski hat. Any will do. 

Neck Warmer- Provides warmth and sun coverage. Buff.

Baseball Cap or other Sun Hat- Any baseball style cap that fits under your helmet comfortably.

Glacier Glasses- Some folks like photochromic lens that adjust to light. They do not need to be marketed as glacier glasses, but there should be good side coverage and they must provide ultimate protection for bright, high-UV conditions. Julbo Montebianco.

Ski Goggles (optional)- For use during the worst weather.

Personal Gear:
Bowl- GSI makes good, simple bowls/mugs/spoons out of Lexan. 

Spoon- Most people like Lexan. Some like a spork.

Mug w/lid- Some folks use a 0.5 liter Nalgene.

Lighters- 1 small disposable.

Toiletries- Nothing but the basics!

Sunscreen- At least SPF 50. A few small tubes are easier to keep thawed and accessible. 

Lip-lube with SPF- SPF 30+  

Journal/pencil

Ear Plugs- Can make for a better night sleep when it’s windy (or if your tent/room-mate snores!).

Phone charging stick- small.

Personal Repair Kit Items (optional)- Keep it light and simple! 

Leatherman/Gerber Tool (optional)- Lightweight, such as the Leatherman Juice.

Small Personal First-Aid Kit/ Medications - Each participant should bring a small kit with blister care and any regular personal medications, plus sufficient quantities of treatment dose altitude medication (acetazolamide 10 x 250 mg) and OTC analgesics (ibuprofen 30 x 200 mg and acetaminophen 20 x 500 mg). We also recommend participants consider bringing dexamethasone (12 x 4 mg oral) and nifedipine (8 x 30 mg extended release version) based on their risk profile and medical history. Instructors will carry a first aid kit with BSI/PPE, trauma, bleeding control, wound care/bandaging, minor splinting supplies, OTC analgesics and antihistamines, and injectable epinephrine, but no other prescription medications.

Hand Sanitizer- 1 or 2oz should be sufficient.

Hand warmers and Toe Warmers (optional)- 3 sets of each.

Trash Compactor Bags (4)- Compactor bags are made from a heavier plastic than “normal” trash bags. Essential to protect equipment from moisture while in your pack. White is nice.

Stuff Sacks- A few of various sizes. At a minimum, 1 for each: sleeping bag, clothes and food. Lightweight. For organizing gear and reducing volume. Exped or Hyperlite.

Travel Stuff:
Travel Clothes- Clean clothes to wear in town and when travelling.

Large Duffel Bag- The North Face Base Camp Duffel Large.

Toiletries, book, etc. (optional)- Extra stuff for use in town .

Group Gear Provided by Remote Rescue Training:
Team rescue equipment
Group repair  and first aid kit 
Glacier travel ropes 
Shovels 
Avalanche probes
Ice screws 
Tents 
Stoves and pots
Fuel  
 
Feel free to bring your own items that overlap with equipment provided by RRT if you would like to use your own equipment or discuss its use. 

Fitness
Alpine mountain climbing and rescue demand endurance, and the importance of good conditioning cannot be overstated. Physical conditioning is the single most important way you can help to ensure a safe and successful training.  It is imperative that you undertake a rigorous conditioning program and arrive in top physical shape.  
Those unable to participate due to physical fitness limitations will be left in town or in camp during daily training exercises. If you are unable to maintain an appropriate pace for travel you may be left in town while others move up to Camp Muir.  You will be responsible for your own travel and accommodations if unable to participate. Inadequate fitness, as per instructors’ discretion, may preclude you from successful completion of the course.  
Each of our training days will be long and strenuous.  Every day will range from 10 to 12 hours in length, hikes of up to 5 miles, pack weights up to 50 pounds, ascents of up to 4000 feet and carrying and hauling patients in litters. You should be prepared physically and mentally for long days in the mountains
Below are some suggestions to get you ready for the physical challenges of this course:
Start training immediately. The more time you have to get in shape, the better.
Cardiovascular training (such as running and cycling) and strength and endurance training (such as weight training, core exercises and stair climbing) should both be included in your program.
Start cardiovascular training by running, biking, hill climbing, or using step machines. Try exercising for an hour or more per session, and keep your heart rate and respirations at a reasonably high level, without over doing it. We recommend a training plan that includes three 60-120 minute training sessions and one 8-10 hour hike with several thousand feet of elevation gain per week. There is no better training for mountain rescue than hiking up and down mountains with a pack in your boots. Begin your training program with a 20-25 pound pack and work up gradually to the length and weight expected (65 pounds) on the course. If there are no hills nearby, stairs work fine for training, especially if you can find a taller multiple storied buildings or stadium steps. 
Begin your strength training by working on muscle groups used in mountaineering. Specifically, you want to target your quadriceps, calves, hamstrings, back, core, hips and shoulder muscles.
When working out in a gym, use stair stepping machines and treadmills- sometimes with a weighted pack and boots. Tilt treadmills up to the full 15 degrees for more benefit. Rowing machines are also excellent for training. Gym training goals: Stair stepper averaging 75 steps per minute for 30 minutes; row 6,000 meters in 30 minutes. It may take a while to build up to those goals. Do both of those exercises in a day, two to three days a week, for 12 weeks leading up to the course. You’ll feel great!
Bottom line: Plan on being in excellent physical condition.

This sounds like a lot of work, and it is. With our daily schedules busy with family, work, and other important commitments, it can be difficult to set aside time for training. But being physically prepared for this DiMM section is the single most important thing you can do to increase your chances of getting the most out of your time on Mount Rainier. Many people like having a personal trainer to help develop a training regimen, to add regularity to training and to hold you accountable.

Pre-Course Skills Preparation
We will move quickly through the basic curriculum, expecting that participants are prepared with some basic skills before the course starts. The WMS DiMM progression normally has folks take the Rock Rescue Session before the Alpine Session, so reviewing basics from the Rock Course should set you up well. Review the skills videos on your DiMM page (available at http://wms.org/education/dimm.asp), and on the Remote Rescue Training YouTube page (https://youtube.com/playlist?list=PLsk31OYIwUUOFUGzEJxRCZ_a-mopg-vXg) to recall the basics. 

Practice individual skills from the Rock Skills and Rescue session and be prepared to demonstrate your proficiency with the skills in the videos when we meet in Washington. We will refine the details and application of these skills during the course, but we expect that you come ready to demonstrate your proficiency.
You will be expected to be able to perform these skills efficiently and consistently at the start of the course. The course progression is designed with base proficiency of these skills prior to the course starting. If you are not competent at these skills it will be difficult to keep up with the pace of the course.
Other technical topics that we will cover, but would be helpful to review (or pre-view) include: multi-point anchoring systems (cordelette style and Frost knot), snow protection (pickets), lowering using ATC’s in series, mechanical advantage systems (simple 3:1 and 5:1, compound 6:1 and 9:1, and complex 5:1 and 7:1), rescue belay techniques (tandem Prusik belay), fixed line ascension (using Prusiks), litter rigging and rope team rigging for glacier travel. We recommend Glacier Mountaineering: An Illustrated Guide to Glacier Travel and Crevasse Rescue and The Mountain Guide Manual.

Pre-Course Reading
Refer to the participant area on your DiMM page (available at http://wms.org/education/dimm.asp) to see which chapters are required reading from the Mountain Medicine and Technical Rescue book. We also recommend that you review the MMTR chapters and handbook from the rock session as well as any other required materials from previous sessions that you don’t remember well (consider in particular the WMS Guidelines on Spine Immobilization, Acute Pain, Altitude Illness, Frostbite and Hypothermia, as well as MMTR chapters 2, 5, 6, 10 and 12). This is the last DiMM session for most participants and you should be working to apply your knowledge and clinical decision making throughout this course. Also, the test assumes a solid understanding of this background information. 

Climbing Fee
Each participant is required to pay a ($53) climbing fee to Mt. Rainier National Park. Please pay this fee online at https://www.pay.gov/public/form/start/79997374 before you travel to Rainier and bring the receipt from pay.gov to show in Paradise. Failure to provide proof of purchase and I.D. will result in being charged the climbing fee again at the park, which will slow down issuance of the climbing permit.

Waiver
Each participant will be required to sign the both the WMS and University of Utah Waiver and Acknowledgment of Risk forms. 

Weapons
Firearms and other weapons are not allowed on any WMS DiMM course. Please leave weapons at home.

Participant:Instructor Ratio
5:1. Maximum enrollment 10. This course will be staffed with 2 Instructors. RRT instructors are highly skilled educators, mountain guides and rescue professionals.

Remote Rescue Training Instructional 
All Remote Rescue Training instructors have a strong background in mountain guiding, technical rescue and wilderness medicine.  Instructor teams are scheduled to maximize strengths.  Currently scheduled (subject to change) to lead the Alpine Skills and Rescue Session are:
Andy Rich- is the Chair of the WMS DiMM Leadership Committee and Program Coordinator for Remote Rescue Training at the University of Utah.  Andy worked for NOLS, guided technical climbing and backcountry skiing all over North America and worked as an Alpine Rescue Specialist in the private sector in remote industrial settings for 15 years before coming to the WMS. Andy is an AMGA Rock Guide and Assistant Alpine and Ski Mountaineering Guide.
Andy Anderson- worked for 15 years as a Rescue Ranger in Grand Teton, Rocky Mountain and Rainier National Parks. Andy is the Technical Search and Rescue Advisor for Tahoe Wilderness Medicine and works as an Avalanche Forecaster at the Sierra Avalanche Center. Andy is also an accomplished long-distance and speed mountain runner.

Evaluation
Participants will be evaluated by field instructors throughout the course in six categories: 
1. Demonstrates safe personal and group practices, 
2. Applies medical skills to the technical arena appropriately, 
3. Maintains appropriate rescue pace, 
4. Technical knowledge and application of rescue systems, 
5. Error correction, and 
6. Leadership, teamwork and communication. 
Participants will then receive a score of:
GREEN: PASS WITHOUT CONCERN; 
YELLOW: BORDERLINE; or 
RED: PRELIMINARY FAIL. 
YELLOW or RED scores will be reviewed by the DiMM Remediation Board.

Candidates are also required to take a 2-hour online exam within 60 days after course completion. The minimum passing score for the online exam is 80%. No more than two attempts will be permitted to pass the online exam. The exam will cover information from the course, the required readings from the Mountain Medicine and Technical Rescue book and WMS Practice Guidelines, and any other materials provided during the course.

Inability to participate in all skills training for any reason (e.g. inadequate fitness, lack of appropriate gear/food, sickness, etc.), inability to meet course expectations (e.g. inadequate preparation, failure to demonstrate basic skill competence, etc.) or poor performance on the online exam may result in removal from the course and/or course failure. The DiMM Remediation Board will consider any borderline or failure cases, possibly resulting in removal from the program or retaking the course at a later date. 

Documents detailing Essential Eligibility Criteria and Evaluation Policy are available on WMS.org, DiMM page, under the Participants and Enrollment & Costs tabs.

COMPLETE THE PRE-COURSE questionnaire by July 1. 

Questions
Please do not hesitate to contact us with any questions you have.  
Contact WMS with questions regarding logistics, ground transportation, payment, etc.  
Contact RRT with questions regarding course content, equipment, food, fitness training