New criteria allow accurate determination of death in mountain rescue situations Evidence-based best practices for making life and death medical decisions in less than ideal circumstances, developed by an international panel and published in Wilderness & Environmental Medicine The International Commission for Mountain Emergency Medicine (ICAR MedCom) convened an expert medical panel to develop evidence-based criteria that allow for accurate determination of death in mountain rescue situations. These recommendations appear in Wilderness & Environmental Medicine, published by Elsevier. Activities in remote mountain areas are associated with an increased risk of critical injury or fatality. Medical emergencies in the wilderness result in worse outcomes than those that occur where help is more accessible.