Citation

Young M, Kim T, Lessard E, Campagne D, Spano S, Farshidpour L, Stroh G. Wilderness Environ. Med. 2018; 29(4): 453-462.

Affiliation

UCSF Fresno Department of Emergency Medicine (Drs Young, Lessard, Campagne, Spano, Stroh, and Ms. Farshidpour); UCSF Fresno Parkmedic Program (Drs Young and Stroh).

Copyright

(Copyright © 2018, Elsevier Publishing)

DOI

10.1016/j.wem.2018.06.009

PMID

30309823

Abstract

INTRODUCTION: The University of California San Francisco Fresno Department of Emergency Medicine provides base hospital support for the Sequoia and Kings Canyon National Parks (SEKI) emergency medical services (EMS) system. This descriptive epidemiologic study reports reasons the park EMS system is used and interventions provided, detailing the nature of patient encounters, type and frequency of injuries and interventions, reasons for base hospital contact, and patient dispositions.

METHODS: Patient charts for all EMS encounters in SEKI from 2011 to 2013 were included, and relevant data were extracted by a single reviewer.

RESULTS: Of the 704 charts reviewed, 570 (81%) were frontcountry patient encounters (within 1.6 km [1 mi] of a paved road); 100 (14%) were backcountry; and 34 (5%) occurred in undefined locations. Regarding sex and age, 58% of patients were men; 22% were younger than 18y, and 15% were 65y or older. More than 80% of calls occurred during the months of June through August. The most common complaints were extremity trauma (24%), torso trauma (13%), and lacerations (9%). Almost 50% of patients were transferred to a higher level of care. Medications were administered to 37% of patients, with oxygen being the most common. Procedures were performed 49% of the time, primarily intravenous access and splinting. Base hospital contact was made 38% of the time, most commonly (54%) for advice regarding disposition.

CONCLUSIONS: SEKI EMS providers encounter a wide variety of patients in various settings, including the backcountry. Resource allocation, training, and protocol development should be tailored to meet their needs.

Copyright © 2018 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.

Language: en

Keywords

EMS; National Park Service; backcountry medicine; wilderness medicine