The Fine Line Podcast Looks at How to Diagnosis and Treat Anaphylaxis...in the Middle of Winter

While many Jackson Hole locals flocked to the Tetons for a day of powder skiing on February 15, 2020, Teton County Search & Rescue volunteers loaded up their heavy packs for a routine day of training on Snow King Mountain.

But the training session quickly turned into anything but routine when longtime TCSAR volunteer Robb Sgroi came down with a rare and severe form of anaphylaxis. The ordeal comes into focus in the next episode of The Fine Line, a podcast from TCSAR Foundation that seeks to raise awareness about backcountry safety and issues affecting first responders.

Most people associate anaphylaxis with bee stings, which of course is not possible in Jackson Hole in the middle of February. Anaphylaxis can also be brought on by food allergies that kick someone’s immune response into overdrive and thereby shut down vital organs. But that’s not what happened here, either.

Robb Sgroi with his wife, Krista, and their daughter, Savannah. Photo: David Bowers

So how did Sgroi—a tall, lean husband and father—end up itchy, on the ground, and spiraling into unconsciousness?

In this episode of The Fine Line, TCSAR volunteers Sgroi, Chase Lockhart and Dr. Will Smith relive this scary incident, and walk us through how to diagnose and treat anaphylaxis, no matter the time of year.

Thank you to Roadhouse Brewing Co. for the generous sponsorship of The Fine Line. We are also grateful to KHOL 89.1 FM for the use of their studio.

This episode airs at 2 p.m. on March 17 on KHOL 89.1 FM, and will be available afterward wherever you get your podcasts.

The Sliver Couloir: The Fine Line Podcast Dissects Intergroup Communication in the Mountains

Like many big ski lines in Grand Teton National Park, the Sliver Couloir was infrequently skied only about 20 years ago. Now, it might see several people in a single day. Fueled by the potent combination of social media and digital mapping, the expense of resort skiing, and the ease of modern equipment, backcountry skiing has reached a fever pitch across the West and the Tetons. 

This increase in skiers means intergroup communication is yet another element people must plan for and accommodate as they head into unforgiving terrain.

Collin Binko ascends the Sliver Couloir in Grand Teton National Park on January 22, 2022. Photo: Courtesy of Michael Martin

The consequences of not communicating became abundantly clear on January 22, 2022, when skiers Collin Binko and Michael Martin encountered a lone snowboarder at the base of the Sliver. All three had eyes on the same prize, but neither party talked to the other. The day ended with the snowboarder descending upon the two skiers, with Martin being overcome by sluffing snow and tumbling several hundred feet to the bottom. He luckily survived, but required a helicopter evac by Grand Teton National Park rangers and Teton County Search & Rescue.

The accident exposed the growing risk of skier-on-skier conflicts in the Tetons, and how critical it is for people to talk to one another in the backcountry, especially in high traffic, high consequence zones like the Sliver.

The next episode of The Fine Line podcast explores this issue head on, with Martin and Binko giving a first-hand account of what happened in the Sliver. We also hear from alpinist and licensed therapist Ryan Burke about coming onto the scene and the dangerous role ego plays in the mountains. Jessica Baker, an AMGA-certified ski guide who has more than two decades of experience in the Tetons, walks us through what communication looks and sounds like in the mountains, and why it’s so critical for everyone’s safety.

The episode airs first at 2 p.m. on Thursday, February 24, on KHOL 89.1 FM, before being available for download on your preferred podcast platform.

The Fine Line is produced by Teton County Search & Rescue Foundation as part of the Backcountry Zero project. The goal of this episode is to offer it up as a learning experience so that similar accidents can be avoided in the future. Thank you to Martin and Binko for sharing their important story, and to Baker and Burke for their valuable insight.

Thanks to Roadhouse Brewing for sponsoring The Fine Line.

TCSAR Earns Winter Accreditation from Mountain Rescue Association

Teton County Search & Rescue recently passed a series of winter-based tests administered by the Mountain Rescue Association (MRA), helping the team earn winter rescue accreditation from the oldest SAR association in the country.

Those who keep a close watch on TCSAR are already aware of the volunteers' high level of commitment and care, but the accreditation demonstrates their skills according to a national set of standards, and is yet another reason for the community to be proud of their efforts.

The accreditation means TCSAR has access to MRA’s extensive network of teams from across the country and advanced training opportunities with outside agencies. “We are constantly seeking ways to improve, and getting feedback from folks outside our organization can identify things we miss internally,” said Doug van Houten, TCSAR’s logistics advisor and team member since 2015. “That we passed with flying colors validates our high training standards and places member expectations inline with industry standards.”

The recent MRA test included 19 TCSAR members who had to demonstrate skills in numerous avalanche rescue and winter emergency scenarios. Photo: David Bowers

The accreditation process consisted of three different field tests on January 22 up on Teton Pass. Nineteen volunteers from TCSAR took part, including nine members from the team’s new class. The team already trains on many of the scenarios featured in the accreditation, but they still ran through the paces during regular team trainings in December and January and practiced on their own time as well. Three members from the local Venture Crew also participated as patients.

The biggest piece was a simulated avalanche rescue, consisting of an unknown number of burials, beacon searches, probe lines, uncovering the buried patients, and providing patient care and transport. The test began with a reporting party saying they had seen an avalanche hit another group of skiers but that they didn’t know how many people were buried. Under the close observation from four MRA accreditors, the team initiated an Incident Command structure, held a safety briefing to set up roles and responsibilities, identified external hazards, and then sprung into action.

Providing a high standard of patient care is a key element to all TCSAR training exercises. Photo: David Bowers

“Through the beacon search, we found two subjects, one was deceased, and another we got a pulse through CPR,” van Houten said of the simulation. “We provided medical care to that patient, and needed to demonstrate rigging for transport. At the same time, we found another subject hiding in the trees. Through that person, we learned that another skier was missing. We initiated a probe line along a series of clues, going fingertip to fingertip, elbow to elbow, and found the last burial subject.”

While the probe line was taking place, other team members were testing on providing patient care and technical rope rigging to transport the first subject. Other parts of the accreditation included an equipment check for five individual members, as well as demonstrating the use of ice axes, crampons, and self-arresting on steep slopes.

To be fully MRA accredited and become a regular member, TCSAR would also need to complete the association’s summer accreditation in Technical Rescue and Search Management. As yet, this hasn’t been scheduled.

“The team values its partnerships and relationships,” van Houten said. “Accreditation provides additional opportunities for TCSAR to network with other mountain rescue teams to both gather and share ideas and best practices.”

During the MRA test, TCSAR had to conduct a probe line based on visual clues to find an avalanche burial victim. A grim but necessary skill for winter rescue in Jackson Hole. Photo: David Bowers