LEBANON — Dartmouth Hitchcock Medical Center has announced a collaboration with a Maine-based mountain guide service to offer the first Diploma in Mountain Medicine (DiMM) program east of the Rocky Mountains.

The program is designed to train physicians, advanced practice providers, nurses and paramedics in mountain rescue and survival, according to a Sept. 10 DHMC news release.

Wilderness medicine takes health care providers from “behind the white doors of a clinical setting,” to situations where equipment and specialists may not be available, Acadia Mountain Guides owner Jon Tierney said last Thursday.

Working in remote settings requires “a lot of critical thinking and learning how to use your rudimentary skills to make good clinical decisions,” he added.

Tierney, who grew up in Cornish, is a registered nurse, a mountain guide and a retired flight paramedic. His company will collaborate with DHMC’s Wilderness and Austere Medicine fellowship program to offer more than 200 hours of hands-on mountain rescue training.

The program can accommodate up to 20 providers per session, with hands-on training taking place in the White Mountains. That will involve summer and winter mountaineering and mountain rescue, avalanche training and wilderness advanced life support, as well as a series of supplemental topics taught by DHMC physicians, Tierney said.

Providing care in remote settings can be challenging due to weather, rugged and remote locations, and a lack of resources, including equipment and specialized providers.

“You can’t always call for what you need,” Tierney said, and the time frame for delivering care remotely is much longer than in a hospital.

By the time a call for help goes out and rescuers arrive on a scene, “there’s a lot of time that the patient is potentially being cared for by bystanders,” without rescue or medical training, Tierney said.

The two other DiMM programs in the U.S., one in New Mexico and one in Utah, are popular and generally full, Tierney said, adding that “it’s nice to see physicians really motivated and excited” for the Northeast version.

“I think it’s going to be a very interesting pairing, putting together the two top organizations in the region that do these things,” Dr. Nicholas Daniel, director of DHMC’s Wilderness and Austere Medicine fellowship, said last Friday.

“Regionally, there is a very strong interest in wilderness medicine,” and he has already received expressions of interest in the program, Daniel said.

“A lot of us in emergency medicine are outdoors people, and it’s a perfect opportunity” to combine two interests, he said. There are many different pathways for wilderness medicine providers, Daniel added. Those who complete the program might serve as doctors for wilderness expeditions, or provide medical direction for search-and-rescue operations.

Austere medicine can encompass any situation where medical resources are limited and transport times to a hospital are long. In our region, that could occur when a natural disaster such flooding that damages bridges or roadways and disrupts travel. Wilderness emergency medical training helps physicians develop “the mindset of how to do these things in a resource-limited environment,” Daniel said.

Training in wilderness and mountain medicine is valuable continuing education, Tierney said.

“It gives providers another way to think about their clinical practice,” he said. “Outside their normal box.”

Christina Dolan can be reached at cdolan@vnews.com or 603-727-3208.