“We are not allowed to give any pain relief” — Swedish mountain-rescue operations from the perspective of mountain-rescue personnel: an interview study

BACKGROUND: Rescue efforts in mountainous terrain remain a challenge for responding organizations such as police, emergency medical services and the mountain rescuers. This study aimed to shed light on Swedish mountain-rescue operations from the perspective of mountain rescuers. METHODS: Individual interviews were conducted with 21 Swedish mountain rescuers from four different counties bordering the 1,700-km long and 300-km wide Swedish/Norwegian mountain range "The Scandes." The collected data were analyzed using qualitative content analysis. RESULTS: The overall theme was "A unique environment demands a tailored response." Five categories were identified: (1) major incident preparedness, (2) intra-organizational preconditions, (3) initial incident response, (4) welfare concerns on-route and on-site, and (5) a difficult injury assessment. CONCLUSION: Intra-organizational bureaucracy may impede Swedish mountain-rescue response. Legislative issues regarding timely access to helicopters for the transportation of personnel and injured, as well as the restrictions on the administration of pain-relief drugs by licensed medical professionals, need to be addressed to decrease time to definitive treatment and improve patient comfort in future rescue efforts.