USU Nursing Students, Faculty Turn Mountain Medicine Training Into Real-Life Rescue Mission

When Karen Zalan slid 200 ft. down a mountain, a nearby group of Uniformed Services University Graduate School of Nursing students and faculty jumped into action to come to her aid.

An injured hiker is packed in a hypothermia prevention management kit prior to being evacuated by USU nursing students and faculty. The USU group had been nearby conducting mountain medicine training. (Photo courtesy of Stewart Zalan)
An injured hiker is packed in a hypothermia prevention management kit prior to being evacuated by USU
nursing students and faculty. The USU group had been nearby conducting mountain medicine training.
(Photo courtesy of Stewart Zalan)

March 14, 2024 by Sharon Holland

Karen and Stewart Zalan were hiking with friends at Smugglers’ Notch State Park near Stowe, Vermont. The couple, who are from Canada, had traveled together with their friends to hike all over the country and in other places like Nepal. This was their second year at Smugglers’ Notch, which is a narrow pass through the Green Mountains, characterized by steep 1,000-foot cliffs, rocky trails, beautiful ponds and stunning scenery.  

A group of three with their backs to the camera carry an injured hiker on a stretcher in the snow.
The team of Army, Navy, and Air Force
nurses were participating in mountain
medicine training when they responded
to the call for help. (Photo courtesy of
Ian Wedmore, USU)
A little more than a half-mile away, a group of students and faculty from the Uniformed Services University’s (USU) Daniel K. Inouye Graduate School of Nursing were participating in mountain medicine training, part of a series of operational readiness training courses offered at USU.  Led by course director Dr. Matt Welder, and assisted by instructors Dr. Ian Wedmore and Dr. Emily Johnston, the nurses were working towards earning their Diploma in Mountain Medicine, learning wilderness medicine, self-sufficiency in the backcountry, and technical rescue, honing their skills in emergency response scenarios, including evacuating patients down a solid wall of ice and across rough terrain.  Periodically, hikers and skiiers would stop by to watch what was happening.  

As Welder explains, “USU is dedicated to ensuring our students are prepared clinically, operationally, physically and emotionally for care anytime or anywhere. We take clinical medicine and adapt to achieve high results in austere conditions. That is what makes us different.”

The Zalan group made their ascent up the trail to the top of the ridge, where there was a landing and stopping point.  The temperature was hovering around 30 degrees, winds were about nine mph, and there was a heavy build-up of ice and frozen snow pack on the trails, making conditions a little challenging.  

Stewart led the way, followed by Karen, with their three friends bringing up the rear.  The approach to the landing was steep, narrow, and slippery, so once Karen got there, she decided to get out of the way to make room for the other hikers by heading a little further up the trail.  

Suddenly, the 75-year-old grandmother lost her footing and started falling head first, on her back, down the trail.  A physiologist, Karen knew how bad it would be for her to hit a tree, so she immediately put her hands above her head to protect herself.  “You can fix bone, but you can’t fix head,” she says she remembers thinking.   

It seemed like she was sliding forever, she says, but it all happened in less than a minute. On the way down, she lost her hat, glasses, and even one of her hearing aids.  As she was sliding, she started to slow, but then she somehow picked up speed again.  When she was finally able to stop, she had gone more than 200 feet down the mountain.  

Karen lay there for a minute, then tried to right herself.  A civilian nurse, who had seen her fall, came over to check on her and help her up.  Karen stood up and assessed her condition.  She was pretty scratched up, her shoulder was sore, but she says she believes the cold masked the true extent of her injuries. In the distance, she could hear her husband calling for her, and she answered, but he didn’t hear her. The nurse helped her walk further down to a cabin at the bottom of the hill and they sat on the steps as her husband and friends made their way to her.  The nurse’s brother came over and he mentioned that nearby there were military members conducting mountain medicine training, so he took off on his downhill skis to summon them. 

Meanwhile, back down the mountain, the USU group was just finishing their avalanche rescue training, and moving on to practice glacier travel skills when the skier approached.  He told them a woman had fallen on a trail and she might need some help.  Immediately, Wedmore and Johnston stopped the training and the USU team grabbed their gear, some rescue equipment and a sked (a rescue sled that can be used across all types of terrain to evacuate patients), and trekked up the mountain to see how they could help.  

A Google Maps screenshot of a trail called Smugglers' Notch
USU students and faculty carried the injured hiker more than a mile, from just beyond Smugglers' Notch to the
parking lot, where she was taken by family and friends to a nearby hospital. (Image credit: Google Maps)

Once they arrived, the group introduced themselves to Karen and asked if they could assist her.  With her permission, she was evaluated by Johnston and Wedmore, both emergency medicine physicians. She was cold, had sustained a number of abrasions to her right forearm which were bleeding, and she was experiencing some pain in her right shoulder and left ribcage when she breathed deeply.  They discovered that her right collarbone was displaced and suspected further injury. They splinted her arm and put it in a sling across her chest to limit movement. The doctors determined she wouldn’t be able to walk the significant distance back down the mountain to her car, so they made the call to carry her out.  

Then, according to Karen, they stood her up, walked her over to the sked that the students and faculty had assembled. 

The USU students – Army Maj. Cody Lachappelle, Navy Lt. Cmdr. David Schulte, Air Force Capt. Lauren Maccoy, Air Force Capt. Dennis Doering, Air Force Capt. Christ McCarty, Army Capt. Joseph Mazzarella, Navy Lt.jg. Matthew Lydon, Navy Lt. Mayra Monarrez – and faculty Army Lt. Col. Shara Fisher from Carl R. Darnall Army Medical Center and Army Lt. Col. Jennifer Fiandt from Madigan Army Medical Center -- had also activated the hypothermia prevention and management kit to ensure she stayed warm. They had her lay down on the sked, checked her vital signs again, placed a pulse oximeter on her finger to monitor her during the evacuation, and placed packs behind her back to provide support as she was transported down the slippery, rocky trail.  

A group of 5 nursing students and faculty stand around an injured hiker on a stretcher in the snow.
Students and faculty from USU's GSN
get ready to evacuate a hiker who was
injured after falling more than 200 ft.
down an icy mountain trail. (Photo
courtesy of Stewart Zalan)
“They wrapped me up like a mummy,” she says. “It was great. They kept asking me if I was okay; if I was feeling all right.”  Karen also says one of her friends joked that she had “done a real service for those people,” giving the USU course participants real-time mountain rescue experience.  

The USU nursing students and faculty then picked up the sked and carried her down the trail to the parking lot, which was a mile away. Oddly, Karen says, the rhythmic sound of their boots, walking in synch and crunching on the frozen path as they carried her, was calming and nearly put her to sleep.  

The team did another assessment before they loaded her into the vehicle, and recommended she go to the University of Vermont emergency department in Burlington for further evaluation of her injuries.  Karen says she, her husband and their friends all headed to the hospital, about an hour away.  

After they left, the group thought about what they had just done. "The right people with the right training and equipment were in the right place at the right time,” said Maccoy. “All of our training just clicked into place like we had been doing cold weather rescues for years." 

At the ER, Karen says medical staff praised the USU group's swift and effective treatment, as well as their bandaging and splinting. They took x-rays, did an ultrasound, and found that her most serious injury was indeed a fractured collarbone.   

Reflecting on the incident, she acknowledged how fortunate she was to escape serious injury. 

“I was incredibly lucky I didn’t hit a hard rock or a tree.  I could have really been seriously injured,” she says. Despite the ordeal, Karen expressed gratitude for the professionalism and kindness shown by the nursing students and faculty. 

“They were so nice. They were so efficient. It was great and I’m just so grateful.”

For one of the USU students, it served to reinforce the importance of training and preparedness. 

“As military providers, we're prepared for various situations, but it's not every day that these skills lead to such a direct, personal impact. Being able to help in this situation was a profound reminder of why we train the way we do,” said Doering. “It's about more than readiness; it's about making a tangible difference in someone's life when they need it most.”