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IntroductionThe global increase in recreational and sports activities in mountainous regions has led to a rise in accidents in these environments. Unlike urban areas, mountain incidents typically occur in remote, hazardous locations with limited access, significantly impacting both patient outcomes and the efficiency of rescue operations, ultimately increasing healthcare costs. In such high-stress situations, cognitive overload, fear, and uncertainty can impair decision making. Tools such as checklists may help compensate for human limitations and support effective response actions.ObjectiveThis study aimed to develop a practical checklist to guide laypersons, regardless of medical background, in the initial management of mountain accident victims. The goal was to enhance patient stabilization, support clinical progression, and potentially reduce strain on healthcare systems.MethodsThe checklist was developed through 2 main phases. First, it was conceptually designed in response to the rising number of mountain-related accidents and the need for a simple cognitive aid. Second, a narrative review of the literature and official guidelines on prehospital trauma care and wilderness first aid was conducted to inform the checklist structure and content.ResultsThe final checklist includes 71 items organized into 6 categories: scene assessment (6 items), alert (9), primary survey (36), secondary survey (13), continuous reassessment (2), and preliminary advice (5).ConclusionThe proposed checklist addresses a wide range of potential scenarios in mountainous environments, encompassing scene and victim safety assessment, emergency medical services activation and early critical interventions.