Experienced Ski Patrol Rescuer Identifies Spinal Injury Before Extraction in Abu Dhabi

The moment

It was a clear, brisk morning in March 2024 when Noor El-Amin was conducting her routine patrol on a newly developed ski slope situated in the remote alpine zone near Abu Dhabi. The terrain was challenging: steep gradients punctuated by variable snow conditions, including patches of firm ice and softer snow, requiring constant vigilance. As she moved along the edge of the slope, she received a radio call reporting an incident nearby—a recreational skier had fallen and was unable to move his lower limbs.

Within moments, Noor arrived at the scene. The skier was lying face down, visibly distressed, with his legs immobile and pain evident upon palpation. The terrain’s steepness and the snow’s unpredictability complicated the rescue. Her immediate assessment was critical, not only to determine the severity of the injury but also to prevent secondary damage during extraction. The scene was remote enough that careful, deliberate action was essential to ensure the patient’s safety and stability before any movement.

Why years of experience made the difference

Noor’s twelve years in mountain rescue, particularly in desert alpine environments, had ingrained a nuanced understanding of injury patterns common in such conditions. Her extensive training covered not only the technical aspects of immobilization equipment but also the subtle clinical signs that distinguish between superficial injuries and more severe trauma, such as spinal cord injuries.

Her familiarity with spinal injury protocols was rooted in repeated drills and real-world application. She routinely practiced neurological assessments, including the use of the American Spinal Injury Association (ASIA) scale, which evaluates motor and sensory function systematically. Her experience had taught her that signs like loss of motor control, diminished sensation, or pain upon palpation—especially in the context of a fall—are red flags for potential spinal trauma.

Moreover, her field expertise included a deep understanding of how to handle the patient without causing secondary injury. She knew that immobilization was not simply about equipment but also about technique: applying cervical collars correctly, securing the patient onto vacuum splints with delicate palpation to avoid exacerbating injuries, and maintaining spinal alignment throughout the rescue process. Years of on-the-ground practice had sharpened her ability to quickly interpret clinical signs and execute protocols seamlessly—skills that cannot be fully mastered through manuals alone but are developed through consistent, deliberate application in varied conditions.

What happened next

Recognising the signs of possible spinal injury—specifically the inability of the skier to move his legs, the pain elicited upon palpation of the lower back, and his unresponsiveness to commands—Noor initiated a structured neurological assessment. She gently tested motor function using the ASIA scale, checking for muscle strength in key muscle groups of the lower limbs and assessing sensory response to light touch and pinprick in dermatomal patterns. Her assessment confirmed a significant deficit consistent with a suspected spinal cord injury.

Next, Noor carefully applied a cervical collar, ensuring proper fit to prevent further cervical movement. She then repositioned the patient onto a vacuum mattress, a specialized immobilisation device that moulds to the patient’s contours, providing rigid support. Her palpation techniques—gently feeling along the spine for tenderness, deformity, or irregularities—were deliberate, avoiding unnecessary pressure that could worsen the injury. Throughout, she maintained verbal communication with the patient, explaining each step to reduce anxiety and to monitor neurological status.

Given the slope’s steepness and the variable snow conditions, Noor coordinated with the rescue team to plan a controlled extraction. They chose a route that minimized movement and avoided unstable snow patches. Using a rescue sled attached to a mechanical winch and a team trained in secure transport, they moved the immobilized patient along the safest path. The careful immobilization, combined with precise coordination, prevented any deterioration of neurological function during the extrication.

The patient was transferred to the medical facility without incident, and subsequent assessments confirmed that no neurological worsening had occurred during rescue. Medical staff later confirmed that the immobilization and careful handling at the scene had likely prevented secondary spinal injury, facilitating prompt and effective treatment.

What this tells us

This case exemplifies how deep, field-specific expertise in injury assessment and immobilization protocols is essential in mountain rescue operations. Recognising subtle signs of spinal trauma, applying correct immobilization techniques, and executing a controlled extraction are interconnected skills honed over years of experience. Proper training combined with practical field application ensures that patients receive appropriate care, reducing the risk of secondary injury and improving outcomes. In environments where terrain and conditions can change rapidly, such expertise remains the critical difference between an effective rescue and a preventable complication.