Wilderness Leaders Must Show Broad Understanding Of Medical Treatment

Main Category: Public Health
Article Date: 23 Dec 2007 - 0:00 PDT

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Organizations that provide group wilderness and adventure experiences mountaineering, rock climbing, river running, sea kayaking, and canoeing are responsible for managing the risk of their courses. The leaders and medical providers of these trips must be prepared to anticipate and manage medical problems that might arise. A new study examined the medical incidents of the National Outdoor Leadership School (NOLS) that occurred within a three-year period, finding low and declining rates of medical incidents. The study is published in the latest issue of Wilderness and Environmental Medicine.

The study examined medical incidents that occurred on wilderness-based courses from September 1, 2002 to August 31, 2005. Injuries occurred at a rate of 1.18 per 1,000 program days and illnesses at a rate of 1.08 per 1,000 program days. No fatalities occurred during the time period. Athletic injuries (like sprains and strains) and gastrointestinal illnesses were the most common medical incidents. Hypothermia, seizures, appendicitis, heat stroke, and pregnancy complications occurred but with low frequency. Fractures, dental emergencies, tick fever, athletic injuries, and non-specific body pains were the conditions most frequently requiring evacuation.

The rate of medical incidents on NOLS courses declined during the 1990s and has remained relatively steady apart from a slight increase in 2004 and 2005. Athletic injuries continue to be a difficulty as they frequently result in evacuation even though their ultimate outcome is usually benign. Evacuation decisions should be made considering both the potential severity of the medical condition as well as patient comfort. Wilderness medical personnel must be familiar with a diverse range of medical conditions in order to provide optimal care.

Wilderness and Environmental Medicine is a peer-reviewed quarterly medical journal published by the Wilderness Medical Society. For more information, visit http://www.wms.org.

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