The pathway to help and safety for injured skiers like Lindsey Vonn is often through the air

CORTINA D’AMPEZZO, Italy (AP) — The whirling of helicopter rotors might be the most feared sound in ski racing.

Skiers wearing little more than lightly padded body suits and helmets hurtling down icy snow at up to 80 mph (130 kph) is scary enough. Crashing into safety nets or tumbling out of control is worse.

Watching them being airlifted off the course — virtually mummified in a stretcher, dangling in mid-air below a hovering chopper by a cable before being whisked away over jagged peaks toward the nearest hospital — is one of the gravest moments in sports.

Lindsey Vonn knows the sound all too well. When the American was airlifted off the Olympia delle Tofana course after a frightening head-over-heels fall during the Olympic downhill on Sunday, it led to her second such helicopter trip in nine days. The first crash, in a World Cup race in Switzerland, ruptured the ACL in her left knee; the second one broke that same leg, led to immediate surgery and possibly ended her career.

“The helicopters add an element of drama to it that is a bit heightened,” Anouk Patty, the chief of sport for U.S. Ski and Snowboard, said shortly after Vonn’s latest evacuation. “But the reality is it’s just the quickest way to get the athletes out to the clinic or the hospital where they need to go.”

Helicopter rescues in Alpine ski racing require close collaboration between local medical staff, team physicians and pilots.

Before the Olympics, The Associated Press interviewed Nicola Cherubin, the rescue specialist who was lowered from the helicopter and brought Vonn up to the aircraft with him on a rope and stayed alongside her while both were hanging outside the cabin during flight.

Privacy rules prevent Cherubin from discussing details of specific rescues, but he confirmed to The AP after Sunday’s crash that he directed the Vonn operation in Cortina.

Helicopter evacuations ‘save lives’

International Ski and Snowboard Federation rules require that “a rescue helicopter or medically equivalent evacuation method must be available on a basis consistent with local law” at all World Cup, world championship and Olympic downhill and super-G races.

And while the rule doesn’t specify it, it actually means that at least two helicopters are required. Because if one chopper is called into action and then has to fly away to a hospital, there needs to be a backup in place.

About an hour before the start of every race, helicopters fly into position. Wind, fog and other weather conditions can ground helicopters, which can mean that races are canceled or postponed.

Helicopter evacuations are often considered more efficient than escorting injured athletes down icy and steep courses on sleds or toboggans, though sleds are still used in certain situations.

“It saves lives,” FIS president Johan Eliasch said. 

When Italian skier Matteo Franzoso died following a crash in preseason training on a course with limited safety fences in Chile in September, a helicopter had to be called in to take him away. The delayed response led to calls for improved safety protocols.

No one wants to hear a code 3 when it comes to skiing accidents

The helicopter crew consists of the pilot, emergency care physicians and a rescue specialist like Cherubin.

“I go down and handle the security on the ground,” Cherubin said. “Then we communicate based on various codes: 01 or 2 means that just I go down and take the athlete up. Then if it’s a Code 3, which means it’s more serious, the doctor comes down, too.”

Injured athletes are first treated by a ground crew of medical personnel based at intervals along the course in coordination with team physicians from the national teams involved in the race.

Once an injured athlete has been hooked up to the rope, Cherubin tells the crew via radio when to start reeling the rope up to the helicopter, usually bringing the stretcher up alongside the cabin but remaining outside.

“When we have short flights of less than a minute, it doesn’t make sense to get inside,” Cherubin said. “It’s quicker just to stay outside and land that way.”

In Cortina, where the race finish is halfway up the mountain and not at the bottom, injured athletes are picked up off the course and flown down to a temporary medical station. Medical personnel from the injured athlete’s team can meet the skier there and help decide on the next course of action.

The options include using another, bigger helicopter to airlift the athlete to a hospital trauma unit, taking the athlete by ambulance to a medical facility in Cortina, or releasing the athlete. In Bormio, where men’s skiing is being contested during the Olympics, Andrea Borromini, an intensive care doctor in the Bormio crew, said helicopter crews there can fly to three different medical facilities.

In Vonn’s case, she was taken farther south, to a hospital in Treviso.

“We often hear on TV that it’s a very serious injury because the helicopter has come. But that’s not always true. It’s just an evacuation system,” said Andrea Apollonio, who is in charge of the medical services at the Cortina races.

Sometimes the injured skiers don’t know they’ve been hurt

Chemmy Alcott, a retired British downhiller turned BBC broadcaster, said she has no memory of being picked up by a helicopter when she suffered compound fractures of the tibia and fibula bones in her right leg during a crash at Lake Louise, Alberta, in 2010.

“Fortunately by that point, I’d been given some morphine. So I was starting to lose my head a little bit — to stop the screaming,” Alcott said. “I only remember it because I’ve seen it in the video.”

Alcott can still relate to the thought process, though, that skiers go through when they realize they’ve lost control.

“You get this crazy slow motion focus,” she said. “So you think about your organs. You think, ‘Right, how am I going to protect my neck, my back?’ You’re going, ‘OK, this is how I’m going to fall.’ And then you have a huge amount of adrenaline, so you never feel pain in the first like 30 seconds. And then it hits you and you’re doing your kind of body scan from top to bottom, and that’s when you know things are bad.”

The emergency care physicians in the helicopter crew know that dealing with athletes immediately after they are injured is nothing like what they deal with in their day jobs.

“They always want to get up right away. So we have to immobilize them and then re-examine them,” said Lydia Rauch, an anesthesiologist who has been in the helicopter crew for years at races in Val Gardena and Cortina. “I’ve treated athletes with severely broken bones who told me that nothing was hurting them. And there could also be other internal injuries that you can’t notice right away.” 

The sound of the helicopter blades can be disturbing to the next skier waiting to start and already dealing with a long delay due to the crash.

Austrian racer Mirjam Puchner was the unfortunate skier in that position for Vonn’s crash on Sunday. Since Vonn fell just a few gates into her run, the helicopter was virtually at eye level for Puchner. 

“All that time you’re hearing that, it’s playing on your nerves,” said Puchner, who was disappointed with her 11th-place finish.

She said she has no memory of her own helicopter evacuation when she broke her right leg in a fall during downhill training at the 2017 world championships in St. Moritz, Switzerland.

“I woke up in the hospital,” she said.

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AP Sports Writer Pat Graham in Bormio contributed.

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AP Olympics: https://apnews.com/hub/milan-cortina-2026-winter-olympics